Organization · Type 2 NPI
Northeast Star Medi
General Practice Physician · Port Jeff Sta, NY
NPI number
1609773340
Active
Practice location
221 Jayne Blvd
Port Jeff Sta, NY 11776-2905
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| General Practice Physician Primary | 208D00000X | None listed |
General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
About NPI 1609773340
Northeast Star Medi's National Provider Identifier is 1609773340, issued on Oct 26, 2026. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Port Jeff Sta, NY. The record was last updated on Oct 26, 2026.