Austin D Prince

NPI #1821768557 in Lake Ronkonkoma, New York

Provider Information

NPI Number: 1821768557
Entity Type: Individual
Name: Austin D Prince
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physician Assistant
Enumeration Date: Sep 14, 2021
Last Updated: Sep 14, 2021

Practice Location

Address: 601 PORTION RD STE 2
City: Lake Ronkonkoma
State: New York
ZIP Code: 11779-4585
Phone: (631) 648-9708

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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