Jordan Michiel, PA-C, MPAS

NPI #1114466216 in Lake Ronkonkoma, New York

Provider Information

NPI Number: 1114466216
Entity Type: Individual
Name: Jordan Michiel, PA-C, MPAS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C, MPAS
Enumeration Date: Feb 22, 2017
Last Updated: Feb 22, 2017

Practice Location

Address: 25 WEICHERS ST
City: Lake Ronkonkoma
State: New York
ZIP Code: 11779-3325
Phone: (631) 922-4617

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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