Individual
AMNA EJAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
75 N COUNTRY RD, PORT JEFFERSON, NY 11777-2119
(631) 686-7654
Mailing address
5 PONDEROSA LN, NESCONSET, NY 11767-3143
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
319027
NY
208M00000X
Hospitalist Physician
Primary
319027
NY
Other
Enumeration date
03/26/2019
Last updated
11/10/2025
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