Port Jefferson Emergency Medical Care

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PORT JEFFERSON EMERGENCY MEDICAL CARE

Doing business as

3 Village Family Medicine

Practice address

7 S Jersey Ave
Suite 1
Setauket, NY 11733-2065

Phone

(631) 689-2700

NPI assigned

Feb 20, 2007

Organization subpart

No

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

Authorized official

Name

William Konczynin, MD

Title

MD

Phone

(631) 689-2700

Specialties & licenses 1

Addresses

Other names 1

• 3 VILLAGE FAMILY MEDICINE Doing business as

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841334968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 438",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117770438",
            "telephone_number": "631-689-2700",
            "fax_number": "631-689-7557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 S JERSEY AVE",
            "address_2": "SUITE 1",
            "city": "SETAUKET",
            "state": "NY",
            "postal_code": "117332065",
            "telephone_number": "631-689-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORT JEFFERSON EMERGENCY MEDICAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KONCZYNIN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "631-689-2700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "3 VILLAGE FAMILY MEDICINE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nicole J Piervencenti, LMHC
• Allison M Pinard, M.A., ATC, EMT-B
• Nicole Paige Polimeni, PA-C
• Kimberly Ann Pope, FNP
• Port Jefferson Chiropractic Office PC
• Jeffrey Porte, M.D.
• Joseph J Pulaski
• Evan Rafferty
• Kiera Ramaliu
• Rena Ferguson, MD, PC

• Family Medicine Physician in Setauket, NY
• Providers in Setauket, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.