Individual
JENNIFER MOLDOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1045 W JERICHO TPKE, SMITHTOWN, NY 11787-3205
(631) 543-8844
(631) 543-8840
Mailing address
1045 W JERICHO TPKE, SMITHTOWN, NY 11787-3205
(631) 543-8844
(631) 543-8840
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
012498
NY
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
012498
LICENSE
NY
Enumeration date
04/02/2008
Last updated
04/30/2024
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