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PORT RADIATION THERAPY PC
NPI 1356412035
Radiology - Diagnostic Radiology in Port Jefferson, NY

Active since November 13, 2006
75 N COUNTRY RD, PORT JEFFERSON, NY 11777(631) 476-2757 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Port Radiation Therapy Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PORT RADIATION THERAPY PC (NPI 1356412035) is a healthcare organization registered as a diagnostic radiology in Port Jefferson, New York and active in the NPI registry since November 2006. The organization lists Edward H Glenn, President, as its authorized official.

NPPES Registry Identity

NPI1356412035
Entity TypeOrganization
Primary Taxonomy2085R0202X
Legal Business NamePORT RADIATION THERAPY PC
Location Address75 N COUNTRY RDPort Jefferson, NY 11777
Mailing Address75 N Country RdPort Jefferson, NY 11777 · (631) 476-2757
Phone(631) 476-2757
Organization SubpartNo
Authorized OfficialEdward H GlennPresident · (631) 476-2757
Enumeration DateNovember 13, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1356412035 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
75 N COUNTRY RD, Port Jefferson, NY 11777
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Other Identifiers 1

Medicaid01643645NY

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JUSTINA CATHERINE MELLONE DO
Student in an Organized Health Care Education/Training Program
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Suffolk County (631) 473-1320
AAKAASH VARMA MD
Dermatology
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Suffolk County (631) 686-2549
KRISELA VOJNIKU MD
Student in an Organized Health Care Education/Training Program
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Suffolk County (631) 686-2549
LORETTA DIDWELL
Physician Assistant
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Suffolk County (631) 473-1320
RAYMOND WONG
Internal Medicine
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Suffolk County (631) 686-7654
KATLYN ANN CONVILLE ANTHONY NP
Nurse Practitioner (Family)
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Suffolk County (631) 686-2565
SHEHNAZ WASIM MD
Internal Medicine
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Suffolk County (631) 686-1443
JULIA KOROBENKO DO
Student in an Organized Health Care Education/Training Program
75 N COUNTRY RD
PORT JEFFERSON, NY 11777
Suffolk County (631) 686-2549

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Port Radiation Therapy PC's NPI number?

The NPI number for Port Radiation Therapy PC is 1356412035. It was assigned to this organization in the NPPES registry on November 13, 2006.

Where is Port Radiation Therapy PC located?

Port Radiation Therapy PC is located at 75 N Country Rd, Port Jefferson, NY 11777. The listed phone number is (631) 476-2757.

What is Port Radiation Therapy PC's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

When was this NPI record last updated?

The NPPES record for Port Radiation Therapy PC was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.