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Organization
VILLAGE INTERNAL MEDICINE GROUP
Active
Organization
VILLAGE INTERNAL MEDICINE GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK J. DIBENEDETTO MD (MD/PRESIDENT)
(631) 474-4000
Entity
Organization
Contact information
Practice address
710 MAIN STREET, PORT JEFFERSON, NY 11777
(631) 474-4000
(631) 474-4011
Mailing address
710 MAIN STREET, VILLAGE INTERNAL MEDICINE GROUP, PORT JEFFERSON, NY 11777
(631) 474-4000
(631) 474-4011
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
172308
NY
Other
Enumeration date
02/09/2006
Last updated
12/29/2010
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