| Sea Medical Wellness Pc | |
|
62 Joline Rd Port Jefferson Station NY 11776-3306 | |
| (631) 656-6231 | |
| Not Available |
| Full Name | Sea Medical Wellness Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 62 Joline Rd, Port Jefferson Station, New York |
| Authorized Official Name and Position | Farhad Gazi (OWNER) |
| Authorized Official Contact | 9173289637 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sea Medical Wellness Pc 62 Joline Rd Port Jefferson Station NY 11776-3306 Ph: (631) 656-6231 | Sea Medical Wellness Pc 62 Joline Rd Port Jefferson Station NY 11776-3306 Ph: (631) 656-6231 |
| NPI Number | 1275373516 |
|---|---|
| Provider Enumeration Date | 05/24/2024 |
| Last Update Date | 06/17/2024 |
| Medicare PECOS PAC ID | 2264974336 |
|---|---|
| Medicare Enrollment ID | O20240604002338 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275373516 | NPI | - | NPPES |
| Provider Name | Farhad Mohammad Gazi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1023278520 PECOS PAC ID: 4284896788 Enrollment ID: I20120430000205 |
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