Shore To Shore Psychiatry P.c. | |
1660 Route 112 Ste C1 Port Jefferson Station NY 11776-8057 | |
(631) 403-6917 | |
(631) 938-1006 |
Full Name | Shore To Shore Psychiatry P.c. |
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Speciality | Psychiatry & Neurology - Psychiatry |
Location | 1660 Route 112 Ste C1, Port Jefferson Station, New York |
Authorized Official Name and Position | Jonathan Esposito (DIRECTOR OF OPERATIONS) |
Authorized Official Contact | 6315389053 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Shore To Shore Psychiatry P.c. 1660 Route 112 Ste C1 Port Jefferson Station NY 11776-8057 Ph: (631) 403-6917 | Shore To Shore Psychiatry P.c. 1660 Route 112 Ste C1 Port Jefferson Station NY 11776-8057 Ph: (631) 403-6917 |
NPI Number | 1558129932 |
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Provider Enumeration Date | 03/11/2024 |
Last Update Date | 03/11/2024 |
Certification Date | 03/10/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1558129932 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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