PORT JEFFERSON MEDICAL WELLNESS, PLLC (NPI# 1053975383) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053975383 |
| Entity Type | Organization |
| Organization Name | PORT JEFFERSON MEDICAL WELLNESS, PLLC |
| Practice Address |
14 Hart Pl Dix Hills NY 11746-6214 |
| Practice Telephone | 7185541042 |
| Practice Fax Number | 6319787622 |
| Mailing Telephone | 7185541042 |
| Mailing Fax Number | 6319787622 |
| Enumeration Date | 2019-04-22 |
| Last Update Date | 2019-04-22 |
| Authorized Official Name | VARUN BAJAJ (ADMIN) |
| Authorized Official Telephone | 7185541042 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Messi Medical Wellness | Doing Business As Name - Organization |
| Street Address |
14 HART PL |
| City | DIX HILLS |
| State | NY |
| Zip Code | 11746-6214 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063044170 | Gail Sackett | Registered Nurse | James E. Allen Learning Center, 762 Deer Park Road, Dix Hills, NY 11746 | 2020-02-06 |
| 1275011835 | Kimberly Susan Tillett | Licensed Practical Nurse | 22 Millet St., Dix Hills, NY 11746 | 2018-08-04 |
| 1225514409 | Mauricio R. Milhoua | Otolaryngology | 16 Marion Place, South Huntington, NY 11746 | 2018-07-11 |
| 1073037032 | Stacy H Schoenbach | Nurse Practitioner | 150 Broadhollow Road Suite 310, Melville, NY 11746 | 2017-08-01 |
| 1124542584 | Molar To Molar Dentistry PC | Dentist | 1679 New York Avenue, Huntington Station, NY 11746 | 2017-07-27 |
| 1114451077 | Ashleigh Lakatos | Specialist/Technologist | 586 Vanderbilt Pkwy, Dix Hills, NY 11746 | 2017-04-18 |
| 1487199170 | Aderemi O. Ogundiran | Student in an Organized Health Care Education/Training Program | 10 Mont Avenue, Dix Hills, NY 11746 | 2017-01-04 |
| 1942758347 | Philopenie Moise | Registered Nurse | 58 Alpine Way, Huntington Station, NY 11746 | 2016-09-14 |
| 1235598996 | Helen Martignette | Registered Nurse | 121 Wolf Hill Rd, Birchwood School, Melville, NY 11746 | 2016-02-23 |
| 1154780963 | Karen Rose Jacobsen | Registered Nurse | 165 Pidgeon Hill Road, South Huntington, NY 11746 | 2016-02-22 |
| Find all providers in zip 11746 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841774403 | Physician Assistant Consulting PC | Clinic/Center | 24 Charter Ave, Dix Hills, NY 11746-6447 | 2018-09-19 |
| 1508033176 | Flower Hill Chiropractic Office, PC | Clinic/Center | 1 Gate Ct, Dix Hills, NY 11746-6755 | 2008-05-13 |
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| 1356942411 | Medical Offices of Occupational Health Resources P C | Clinic/Center | 240 Airport Rd, White Plains, NY 10604-1315 | 2020-11-05 |
| 1649884537 | Bridge To Care Nurse Practitioner In Psychiatry PC | Clinic/Center | 3005 Church Ave, Brooklyn, NY 11226-4209 | 2020-09-08 |
| 1093328890 | Philomene Goueliani Phd | Clinic/Center | 1461 E 103rd St, Brooklyn, NY 11236-4513 | 2020-08-31 |
| 1801409792 | Lori Davis, Np In Family Health Pllc | Clinic/Center | 317 N Aurora St Ste 200a, Ithaca, NY 14850-4201 | 2020-08-28 |
| 1679190326 | Payless Staffing and Consultants | Clinic/Center | 1332 Commerce Ave Frnt 3, Bronx, NY 10461-3612 | 2020-06-29 |
| 1487279238 | Nss Medical Services, Pllc | Clinic/Center | 322 Linden Blvd., Ground Floor, Brooklyn, NY 11226 | 2020-06-08 |
| 1275157000 | Provident Health Partners Inc. | Clinic/Center | 1529 N Ocean Ave Ste A, Medford, NY 11763-3587 | 2020-06-08 |
| 1922635218 | Proficient Rehab Care Pt Pllc | Clinic/Center | 121 Winham Ave, Staten Island, NY 10306-4930 | 2020-03-25 |
| 1104451525 | Dr Paul Poulakos Do, LLC | Clinic/Center | 186 9th Ave Apt 4f, New York, NY 10011-4918 | 2020-03-05 |
| 1538793732 | Yi Zhang Medical Wellness Pllc | Clinic/Center | 3815 Corporal Stone St Fl 2, Bayside, NY 11361-2140 | 2020-02-26 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.