| Doctor Name: | JOEL LA WATSON |
| NPI Number: | 1003968132 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.A |
| License Number: | 008600 |
| Business Practice Address: | 4295 Hempstead Tpke Bethpage, NY - 117145713 |
| Business Phone Number: | 5165796000 |
| Business Fax Number: | |
| Mailing Address: | 21 Crowell St, HEMPSTEAD |
| State: | NY |
| Postal Code: | 115505113 |
| Phone Number: | 5165388697 |
| Fax Number: | |
| NPI Enumeration Date: | 01/17/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 008600 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |