Individual provider · Type 1 NPI

Jillian Prospect

Specialist · Port Jefferson Station, NY

NPI number 1003312836 Active

Practice location

299 Hallock Ave
Port Jefferson Station, NY 11776

Call (631) 473-4284 Map

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000XNone listed

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1003312836

Jillian Prospect's National Provider Identifier is 1003312836, issued on Apr 2, 2018. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Port Jefferson Station, NY. The record was last updated on Aug 3, 2018.