Organization
COMMUNITY MEDICAL WELLNESS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER DEFILIPPIS (OPERATIONS MANAGER)
(516) 314-5377
Entity
Organization
Contact information
Practice address
1041 ROUTE 112, PORT JEFFERSON STATION, NY 11776-6000
(516) 314-5377
Mailing address
PO BOX 463, FARMINGVILLE, NY 11738-0463
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
276810-1
NY
Other
Enumeration date
05/02/2018
Last updated
05/02/2018
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