| Doctor Name: | JOLANTA MYCHAJLYSZYN |
| NPI Number: | 1023188059 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RPA-C |
| License Number: | 007260-1 |
| Business Practice Address: | 2000 N Village Ave Suite 402 Rockville Centre, NY - 115701078 |
| Business Phone Number: | 5167662519 |
| Business Fax Number: | 5167663714 |
| Mailing Address: | 2296 Garfield St, NORTH BELLMORE |
| State: | NY |
| Postal Code: | 117102106 |
| Phone Number: | 5166795991 |
| Fax Number: | 5167663714 |
| NPI Enumeration Date: | 11/08/2006 |
| NPI Last Update Date: | 03/12/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 007260-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |