Organization
BAYPORT MEDICAL GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLORIA DELFINO (BILLING MANAGER)
(631) 472-0600
Entity
Organization
Contact information
Practice address
10 S SNEDECOR AVE, BAYPORT, NY 11705-2133
(631) 472-0600
(631) 472-0602
Mailing address
10 S SNEDECOR AVE, BAYPORT, NY 11705-2133
(631) 472-0600
(631) 472-0602
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
196926
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01771315
—
NY
Enumeration date
11/12/2009
Last updated
11/12/2009
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