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Organization
SEA MEDICAL WELLNESS PC
Active
Organization
SEA MEDICAL WELLNESS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FARHAD GAZI MD (OWNER)
(917) 328-9637
Entity
Organization
Contact information
Practice address
62 JOLINE RD, PORT JEFFERSON STATION, NY 11776-3306
(631) 656-6231
Mailing address
62 JOLINE RD, PORT JEFFERSON STATION, NY 11776-3306
(631) 656-6231
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
Other
Enumeration date
05/24/2024
Last updated
06/17/2024
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