1. Home
  2. Directory
  3. New York
  4. Port Jefferson Station
  5. Emergency Medicine
  6. NPI Profile

11 MEDICAL DRIVE WELLNESS PLLC
NPI 1902332588
Emergency Medicine - Emergency Medical Services in Port Jefferson Station, NY

Active since May 03, 2017
11 MEDICAL DR, SUITE B, PORT JEFFERSON STATION, NY 11776(631) 509-6066(631) 849-5824 Get Directions Write a Review

NPPES record last updated: May 3, 2017. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About 11 Medical Drive Wellness Pllc NPPES

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

11 MEDICAL DRIVE WELLNESS PLLC (NPI 1902332588) is a healthcare organization registered as an emergency medical services in Port Jefferson Station, New York and active in the NPI registry since May 2017. The organization lists Laura Roy, Practice Manager, as its authorized official.

NPPES Registry Identity

NPI1902332588
Entity TypeOrganization
Primary Taxonomy207PE0004X
Legal Business Name11 MEDICAL DRIVE WELLNESS PLLC
Location Address11 MEDICAL DR, SUITE BPort Jefferson Station, NY 11776-1589
Mailing Address11 Medical Dr, Suite BPort Jefferson Station, NY 11776-1589 · (631) 509-6066 · Fax (631) 849-5824
Phone(631) 509-6066
Fax(631) 849-5824
Organization SubpartYesParent: Dh Management Group Llc
Authorized OfficialLaura RoyPractice Manager · (631) 805-6384
Enumeration DateMay 3, 2017
✔ NPI 1902332588 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency Medicine · Emergency Medical ServicesAllopathic & Osteopathic Physicians
Taxonomy Code207PE0004X
Definition

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 DR, Port Jefferson Station, NY 11776
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

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

COLLEEN BREEN JOHNSON PA-C
Physician Assistant
11 MEDICAL DR
PORT JEFFERSON STATION, NY 11776
Suffolk County (631) 509-6066
GREGORY J DIEHL MD PC
Clinic/Center (Medical Specialty)
11 MEDICAL DR, SUITE B
PORT JEFFERSON STATION, NY 11776
Suffolk County (631) 476-7300
HOLISTIC MEDICAL WELLNESS, PLLC
Emergency Medicine
11 MEDICAL DR
PORT JEFFERSON STATION, NY 11776
Suffolk County (646) 239-1656

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 11 Medical Drive Wellness PLLC's NPI number?

The NPI number for 11 Medical Drive Wellness PLLC is 1902332588. It was assigned to this organization in the NPPES registry on May 3, 2017.

Where is 11 Medical Drive Wellness PLLC located?

11 Medical Drive Wellness PLLC is located at 11 Medical Dr Suite B, Port Jefferson Station, NY 11776. The listed phone number is (631) 509-6066.

What is 11 Medical Drive Wellness PLLC's specialty?

The primary specialty registered for this NPI is Emergency Medicine, specializing in Emergency Medical Services, with taxonomy code 207PE0004X.

When was this NPI record last updated?

The NPPES record for 11 Medical Drive Wellness PLLC was last updated on May 3, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.