MICHELLE JACK

STONY BROOK, NY
NPI1831631779
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: NY  020374)
Enumeration Date2016-11-09
Last Update Date2019-06-27
Business Address
MICHELLE JACK PA-C
STONY BROOK UNIV HOSP 101 NICOLLS ROAD HSC L-4 RM050
STONY BROOK, NY 11794-4927
Phone number: 631-444-2478
Mailing Address
MICHELLE JACK PA-C
PO BOX 1559
STONY BROOK, NY 11790-0989
Phone number: 631-444-2478
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