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General NPI Number Information
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NPI Number | 1891090759
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Entity Type | Organization
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Legal Business Name | MARKELLA CHRISTAKIS MD PC
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Dates
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Enumeration Date | 01/24/2011
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Last Update Date | 01/24/2011
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Provider Practice Location Address
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Address Line | 70 N COUNTRY RD SUITE 201
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City | PORT JEFFERSON
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State | NY
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Zip | 11777-2161
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Country | US
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Telephone | 631-403-4310
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Fax |
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Provider Business Mailing Address
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Address Line | 70 N COUNTRY RD SUITE 201
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City | PORT JEFFERSON
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State | NY
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Zip | 11777-2161
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Country | US
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Telephone | 631-403-4310
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARKELLA MICHAEL CHRISTAKIS
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Credential | MD
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Telephone | 631-403-4310
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 257297
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License Number State | NY
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