VARICOSE VEIN MEDICAL OFFICE PC
Medical Practice at Main St, Prt Jefferson Station, NY

License number
New York 17481001
Category
Medical Practice
Type
Phlebology
Owner
Name: MS. CAROLYN HEALY
Title: MANAGER
Phone: (631) 331-0500
Address
Address
405 E Main St, Prt Jefferson Station, NY 11777
National Provider ID: 1174753875
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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VARICOSE VEIN MEDICAL OFFICE, PC

Prt Jefferson Station, NY  -  Miller Place, NY

Registration:
Feb 2, 2011
Addresses:
405 E Main St, Port Jefferson, NY 11777 (Physical)
405 E Main St, Miller Place, NY 11764 (Physical)
State ID:
4050214
Business type:
DOMESTIC PROFESSIONAL CORPORATION
Jerry G Ninia Md, 405 E Main St, Port Jefferson, NY 11777 (Physical)

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