| Port Jefferson Medical Wellness, Pllc | |
|
14 Hart Pl Dix Hills NY 11746-6214 | |
| (718) 554-1042 | |
| (631) 978-7622 |
| Full Name | Port Jefferson Medical Wellness, Pllc |
|---|---|
| Speciality | Clinic/center |
| Location | 14 Hart Pl, Dix Hills, New York |
| Authorized Official Name and Position | Varun Bajaj (ADMIN) |
| Authorized Official Contact | 7185541042 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Port Jefferson Medical Wellness, Pllc 14 Hart Pl Dix Hills NY 11746-6214 Ph: (718) 554-1042 | Port Jefferson Medical Wellness, Pllc 14 Hart Pl Dix Hills NY 11746-6214 Ph: (718) 554-1042 |
| NPI Number | 1053975383 |
|---|---|
| Provider Enumeration Date | 04/22/2019 |
| Last Update Date | 04/22/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053975383 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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