NPI 1174753875

Varicose Vein Medical Office PC

Organisation Phlebology Physician Port Jefferson, NY

Practice location

Address: 405 E Main St, Port Jefferson, NY 11777-1868
Phone: (631) 474-1414

Authorised official

Name: Carolyn Healy
Title: Manager
Phone: (631) 331-0500

Registered specialties

Phlebology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 202K00000X Licence 17481001 (NY)

Other Phlebology providers in New York →

Registry record

NPI: 1174753875
Entity type: Organization
NPI issued: 16 Jul 2009
Record last updated: 16 Mar 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.