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General NPI Number Information
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NPI Number | 1225786106
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Entity Type | Organization
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Legal Business Name | HARBOR MEDICAL WELLNESS PC
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Dates
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Enumeration Date | 03/10/2022
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Last Update Date | 03/10/2022
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Provider Practice Location Address
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Address Line | 640 BELLE TERRE RD BLDG J
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City | PORT JEFFERSON
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State | NY
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Zip | 11777-1936
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Country | US
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Telephone | 631-885-2364
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Fax |
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Provider Business Mailing Address
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Address Line | 32 ROSLYN CT
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City | PORT JEFFERSON
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State | NY
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Zip | 11777-1433
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Country | US
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Telephone | 631-885-2364
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | FRANK LUNATI
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Credential | MD
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Telephone | 631-885-2364
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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