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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