GREGORY J DIEHL MD PC NPI 1235436130

NPI Information

  • NPI: 1235436130
  • Provider Name: GREGORY J DIEHL MD PC
  • Classification: Clinic/Center - 261QM2500X
  • Specialization: Medical Specialty
  • Entity Type: Organization
  • Address: 11 MEDICAL DR
    SUITE B
    PORT JEFFERSON STATION, NY
    ZIP 11776
  • Phone: (631) 476-7300

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NPI Details

GREGORY J DIEHL MD PC is a medical specialty clinic center in Port Jefferson Station, NY. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). GREGORY J DIEHL MD PC NPI is 1235436130. The provider is registered as an organization entity type.

The provider's business location address is:

11 MEDICAL DR
SUITE B
PORT JEFFERSON STATION, NY
ZIP 11776-589
Phone: (631) 476-7300
Fax: (631) 476-7304

The provider's authorized official is Gregory J Diehl .
The authorized official title is President and has the following contact phone number (631) 476-7300.

The enumeration date for this NPI number is 2/12/2011 and was last updated on 2/12/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM2500XClinic/CenterMedical Specialty1902162NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11447249214OTHERNEW YORKNPI
289K831MEDICARE PINNEW YORK
3E87758MEDICARE UPINNEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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