Individual
DR. JONATHAN PHILIP MINTZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
STONY BROOK UNIVERSITY MEDICAL CTR, HSC T-11, ROOM 020, STONY BROOK, NY 11794-8111
(631) 444-7653
Mailing address
STONY BROOK UNIVERSITY MEDICAL CTR, HSC T-11, ROOM 020, STONY BROOK, NY 11794-8111
(631) 444-7653
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
240685
NY
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
240685
NY
Other
Enumeration date
07/26/2007
Last updated
06/13/2012
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