11 MEDICAL DRIVE WELLNESS PLLC – NPI #1902332588
Emergency Medicine

An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients.

11 MEDICAL DRIVE WELLNESS PLLC is a provider located in PORT JEFFERSON STATION, NY. NPPES has assigned the NPI number 1902332588 to 11 MEDICAL DRIVE WELLNESS PLLC on May 03, 2017. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 207PE0004X from the Health Care Provider Taxonomy code set, which is classified as Emergency Medicine, specializing in Emergency Medical Services

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for 11 MEDICAL DRIVE WELLNESS PLLC below.

NPI Profile for
11 MEDICAL DRIVE WELLNESS PLLC

NPI Number
1902332588
Enumeration Date

(more than 9 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
11 MEDICAL DRIVE WELLNESS PLLC
Primary location
11 MEDICAL DR
SUITE B
PORT JEFFERSON STATION, NY 11776-1589
Phone: (631) 509-6066 Fax: (631) 849-5824
Mailing address
Same as primary location
Organization Subpart
Yes - 11 MEDICAL DRIVE WELLNESS PLLC is subpart of another organization.
Authorized Official
LAURA ROY
PRACTICE MANAGER
Phone: (631) 805-6384
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207PE0004X
- Emergency Medicine / Emergency Medical Services (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.