Basic Information
| Provider Information | |||||||||
| NPI: | 1659761450 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ARAUJO | ||||||||
| FirstName: | JEANNE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | PHYSICIAN ASSISTANT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 333 ROUTE 25A | ||||||||
| Address2: | SUITE 225 | ||||||||
| City: | ROCKY POINT | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117788556 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6317443671 | ||||||||
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| Practice Location | |||||||||
| Address1: | 70 N COUNTRY RD | ||||||||
| Address2: | SUITE 203 | ||||||||
| City: | PORT JEFFERSON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117772161 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6314740707 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/31/2015 | ||||||||
| LastUpdateDate: | 05/20/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 018285 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.