OrganizationActive
Varicose Vein Medical Office PC
NPI 1174753875 · Phlebology Physician · Port Jefferson, NY
Provider details
- NPI number
- 1174753875
- Entity type
- Organization
- Primary specialty
- Phlebology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Carolyn Healy, Manager(631) 331-0500
- License
- 17481001 (NY)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
405 E Main St
Port Jefferson, NY 11777-1868
Phone: (631) 474-1414
Approximate (ZIP-level) locationGet directions
Mailing address
405 E Main St
Port Jefferson, NY 11777-1868
Registry dates
- Enumerated
- 2009-07-16
- Last updated
- 2015-03-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.