Organization
PORT JEFFERSON SURGICAL PC
Active
Organization
PORT JEFFERSON SURGICAL PC
Active
Other names
Port MD Medical Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
MARKELLA CHRISTAKIS (BILLING)
(631) 403-4310
Entity
Organization
Contact information
Practice address
1227 MAIN ST STE 101, PORT JEFFERSON, NY 11777-2227
(718) 554-1042
Mailing address
70 N COUNTRY RD STE 201, PORT JEFFERSON, NY 11777-2161
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
04/09/2019
Last updated
10/01/2019
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