Jillian Prospect
NPI #1003312836 in Port Jefferson Station, New York
Provider Information
- NPI Number
- 1003312836
- Entity Type
- Individual
- Name
- Jillian Prospect
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Specialist
- Enumeration Date
- Apr 2, 2018
- Last Updated
- Aug 3, 2018
Practice Location
- Address
- 299 HALLOCK AVE
- State
- New York
- ZIP Code
- 11776
- Phone
- (631) 473-4284
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist |
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