Three Village Medicine PC
Family Medicine in Port Jefferson, NY. Organization (NPI-2).
NPI number1982108353
StatusActive
Last updated in NPPESMar 21, 2018
Details
- NPI
- 1982108353
- Entity type
- Organization (NPI-2)
- Legal business name
- Three Village Medicine PC
- Organization subpart
- No
- Enumeration date
- Mar 21, 2018
- Last updated
- Mar 21, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Practice location
24 Jefferson Landing CirPort Jefferson, NY 11777-1978
Phone 516-946-0000
Mailing address
24 Jefferson Landing CirPort Jefferson, NY 11777-1978
Phone 516-946-0000
Authorized official
Syed Shabahat Hussain
Ceo
5169460000
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