# GREGORY J DIEHL MD PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235436130
- **Authorized official:** GREGORY J DIEHL MD (PRESIDENT)
- **Authorized official phone:** (631) 476-7300

## Contact information

- **Practice address:** 11 MEDICAL DR, SUITE B, PORT JEFFERSON STATION, NY 11776-1589
- **Practice address phone:** (631) 476-7300
- **Practice address fax:** (631) 476-7304
- **Mailing address:** 11 MEDICAL DR, SUITE B, PORT JEFFERSON STATION, NY 11776-1589
- **Mailing address phone:** (631) 476-7300
- **Mailing address fax:** (631) 476-7304

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 1902162 | NY | Yes |

## Other

- **Enumeration date:** 02/12/2011
- **Last updated:** 02/12/2011