Organization
VARICOSE VEIN MEDICAL OFFICE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CAROLYN HEALY (MANAGER)
(631) 331-0500
Entity
Organization
Contact information
Practice address
405 E MAIN ST, PORT JEFFERSON, NY 11777-1868
(631) 474-1414
Mailing address
405 E MAIN ST, PORT JEFFERSON, NY 11777-1868
(631) 474-1414
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
Primary
17481001
NY
Other
Enumeration date
07/16/2009
Last updated
03/16/2015
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