Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Custom Trt US Inc

Organization Medical Specialty Clinic/Center · NPI 1528883725

Custom Trt US Inc is a Medical Specialty Clinic/Center in Port Jefferson Station, New York. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

69 Clymer St
Port Jefferson Station, NY 11776
Phone: (631) 260-1945
Fax: (631) 403-1298
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Specialty Clinic/Center (primary) Taxonomy 261QM2500X

Record details

NPI number1528883725
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Amanda Wiermann — President · (516) 652-6509
Other names Custom Trt
NPI enumeratedNovember 21, 2024
Last updated in NPPESNovember 21, 2024
Certification dateNovember 21, 2024
Mailing addressP.O. Box 263, Port Jefferson Station, NY 11776

Other providers in Port Jefferson Station