MJ NP in Family Health Care P. C.

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

MJ NP IN FAMILY HEALTH CARE P. C.

Practice address

163 Poospatuck LN
Mastic, NY 11950-5201

Phone

(631) 394-5310

NPI assigned

Apr 13, 2020

Last updated

Apr 13, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michelle Ann Jackson, FNP

Title

FNP

Phone

(631) 394-5310

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1586736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586736000000",
    "number": "1578182275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 273",
            "city": "MASTIC",
            "state": "NY",
            "postal_code": "119500273",
            "telephone_number": "631-394-5310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 POOSPATUCK LN",
            "city": "MASTIC",
            "state": "NY",
            "postal_code": "119505201",
            "telephone_number": "631-394-5310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MJ NP IN FAMILY HEALTH CARE P. C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-13",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "FNP",
        "authorized_official_telephone_number": "631-394-5310",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne Irene Messina
• Catherine V Miller, LPN
• Gail Robin Miller, R.N.
• Katelyn Angela Miller, LPN
• Michael Miller
• Moes Taxi Ride, Inc
• Syteria Renee Mohawk
• Alexandra Mondi, LPN
• Graciela Montalvo, CASAC
• Montauk Chemists Inc (River Pharmacy and Surgicals)

• Health Service Clinic/Center in Mastic, NY
• Providers in Mastic, NY by specialty
• Health Service Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.