Most Relevant Information
Provider Data
| NPI Number: | 1003474834 |
| Provider Name: | JOSEPH E MIRRO |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 024653 |
Most Important Dates
| Enumeration Date: | 06/05/2019 |
| Last Updated: | 12/10/2020 |
Provider Practice Location
518 HUNTER AVE
WEST ISLIP
NY
117951641
Practice Location Phone/Fax
| Phone: | 6312789888 |
| Fax: |
Provider Mailing Location
518 HUNTER AVE
WEST ISLIP
NY
117951641
Provider Mailing Phone/Fax
| Phone: | 6312789888 |
| Fax: |