Organization
COASTAL MEDICAL SERVICES OF NY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY BREVETTI MD (OWNER)
(917) 575-8907
Entity
Organization
Contact information
Practice address
1500 ROUTE 112 STE B, PORT JEFFERSON STATION, NY 11776-8055
(917) 575-8907
Mailing address
1500 ROUTE 112 STE B, PORT JEFFERSON STATION, NY 11776-8055
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
12/21/2021
Last updated
03/14/2023
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