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Mr. Jaymie Eureko Oentoro, MD
Student in an Organized Health Care Education/Training Program in Stony Brook, New York
NPI 1588293682

Jaymie Eureko Oentoro is a Student in an Organized Health Care Education/Training Program based in Stony Brook, NY. Jaymie Eureko Oentoro practices in Stony Brook, NY and has the professional credentials of MD. The NPI Number for Jaymie Eureko Oentoro is 1588293682 and holds a License No. (New York).

The current practice location address for Jaymie Eureko Oentoro is 101 Nicolis Road, Stony Brook, NY and can be reached out via phone at 631-444-2224.

Location: 101 Nicolis Road, Stony Brook, NY, 11794-7025
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1588293682
Provider Name
Jaymie Eureko Oentoro
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
101 Nicolis Road, Stony Brook, NY, 11794-7025
Phone Number
631-444-2224
Fax Number
Provider Enumeration Date
04/02/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
101 Nicolis Road
City
Stony Brook
State
New York
Zip
11794-7025
Phone Number
631-444-2224
Fax Number
person
Provider Business Mailing Address Details
Address
101 Nicolis Road
City
Stony Brook
State
New York
Zip
11794-7025
Phone Number
631-444-2224
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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