| Port Jeff Medicine, P.c. | |
|
2 Medical Dr Ste D Port Jeff Sta NY 11776-1598 | |
| (631) 331-5010 | |
| (631) 331-5017 |
| Full Name | Port Jeff Medicine, P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 2 Medical Dr Ste D, Port Jeff Sta, New York |
| Authorized Official Name and Position | Deepti Gupta (PRESIDENT/OWNER) |
| Authorized Official Contact | 6313315010 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Port Jeff Medicine, P.c. 2 Medical Dr Ste D Port Jefferson Station NY 11776-1598 Ph: (631) 331-5010 | Port Jeff Medicine, P.c. 2 Medical Dr Ste D Port Jeff Sta NY 11776-1598 Ph: (631) 331-5010 |
| NPI Number | 1346770484 |
|---|---|
| Provider Enumeration Date | 06/12/2017 |
| Last Update Date | 06/19/2017 |
| Medicare PECOS PAC ID | 5799059325 |
|---|---|
| Medicare Enrollment ID | O20170921000007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346770484 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 196816 (New York) | Primary |
| Provider Name | Deepti Gupta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619936069 PECOS PAC ID: 4385670645 Enrollment ID: I20050709000045 |
Harvey Steven Schwartzberg Md Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 18 Roosevelt Ave, Port Jeff Sta, NY 11776 Phone: 631-928-3327 Fax: 631-828-5505 |