Individual
JISMI JOSHY VATHIELIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
101 NICOLLS RD, STONY BROOK, NY 11794-0001
(631) 689-8333
Mailing address
5951 NW 80TH TER, PARKLAND, FL 33067-1128
(954) 240-4875
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN11037894
FL
Other
Enumeration date
11/25/2020
Last updated
06/10/2025
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