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Organization
11 MEDICAL DRIVE WELLNESS PLLC
Active
Organization
11 MEDICAL DRIVE WELLNESS PLLC
Active
Parent organization
DH MANAGEMENT GROUP LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
DH MANAGEMENT GROUP LLC
Authorized official
LAURA ROY (PRACTICE MANAGER)
(631) 805-6384
Entity
Organization
Contact information
Practice address
11 MEDICAL DR, SUITE B, PORT JEFFERSON STATION, NY 11776-1589
(631) 509-6066
(631) 849-5824
Mailing address
11 MEDICAL DR, SUITE B, PORT JEFFERSON STATION, NY 11776-1589
(631) 509-6066
(631) 849-5824
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
—
NULL
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
—
—
Other
Enumeration date
05/03/2017
Last updated
05/03/2017
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