Provider Demographics
NPI:1548804180
Name:MUNZ, JOSEPH JOHN (PA)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:JOHN
Last Name:MUNZ
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 DEAUVILLE PKWY
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11757-6005
Mailing Address - Country:US
Mailing Address - Phone:631-972-4353
Mailing Address - Fax:
Practice Address - Street 1:108 DEAUVILLE PKWY
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:NY
Practice Address - Zip Code:11757-6005
Practice Address - Country:US
Practice Address - Phone:631-972-4353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-06
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant