Organization
PORT JEFF MEDICAL CARE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT MORMANDO D.O. (PRESIDENT/CEO)
(631) 642-2025
Entity
Organization
Contact information
Practice address
410 HALLOCK AVE, PORT JEFFERSON STATION, NY 11776-1232
(631) 642-1100
(631) 642-1190
Mailing address
410 HALLOCK AVE, PORT JEFFERSON STATION, NY 11776-1232
(631) 642-1100
(631) 642-1190
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
200407
NY
207RN0300X
Nephrology Physician
Primary
178674
NY
Other
Enumeration date
07/13/2006
Last updated
09/11/2025
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