Gregory J Diehl MD PC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

1902162 Issued in NY

Legal business name

GREGORY J DIEHL MD PC

Practice address

11 Medical Dr
Suite B
Port Jefferson Station, NY 11776-1589

Phone

(631) 476-7300

Fax

(631) 476-7304

NPI assigned

Feb 12, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gregory J Diehl, MDNPI 1447249214

Title

President

Phone

(631) 476-7300

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gregory John Diehl, MD

  • Plastic Surgery Physician
  • Port Jefferson Station, NY
  • NPI 1447249214
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1297468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297468800000",
    "number": "1235436130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 MEDICAL DR",
            "address_2": "SUITE B",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761589",
            "telephone_number": "631-476-7300",
            "fax_number": "631-476-7304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 MEDICAL DR",
            "address_2": "SUITE B",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761589",
            "telephone_number": "631-476-7300",
            "fax_number": "631-476-7304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREGORY J DIEHL MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-12",
        "last_updated": "2011-02-12",
        "status": "A",
        "authorized_official_last_name": "DIEHL",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-476-7300",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NY",
            "license": "1902162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1447249214",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Iris Ann Granek, M.D.
• Arron Jordan Gravina
• Katherine McCauley Graziano, OTR/L, PT, DPT, CLT
• Keriann Marie Greehy, LPN
• Karen Greenwood, M.S.W.
• Salema Shirelle Griffith
• Veronica A Groth, N.P.P
• Susan Grover, N.P.P., C.S
• Rebekah Guastella, M.S., CF-SLP, TSSLD
• Adriana Guigova, DO

• Medical Specialty Clinic/Center in Port Jefferson Station, NY
• Providers in Port Jefferson Station, NY by specialty
• Medical Specialty Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.