Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jacquelyn Mitra

Individual provider Specialist · NPI 1528882743

Jacquelyn Mitra is a Specialist in Port Jefferson Station, New York. Registered with an NPI since 2024.

In the registry since
2024

Practice location Address checks out

299 Hallock Ave
Port Jefferson Station, NY 11776-1217
Phone: (631) 469-3842
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X

Record details

NPI number1528882743
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedNovember 13, 2024
Last updated in NPPESNovember 13, 2024
Certification dateNovember 12, 2024

Other providers in Port Jefferson Station