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

Lake Family Medical Practice PC

Organization Family Medicine Physician · NPI 1639923675

Lake Family Medical Practice PC is a Family Medicine Physician in Lake Ronkonkoma, New York. Registered with an NPI since 2024.

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

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Practice location Address checks out

201 Portion Rd Ste A
Lake Ronkonkoma, NY 11779-4172
Phone: (631) 981-1333
Fax: (631) 981-2326
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1639923675
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Robert Tufano — Ceo · (631) 981-1333
NPI enumeratedApril 16, 2024
Last updated in NPPESNovember 13, 2024
Certification dateNovember 13, 2024
Mailing address201 Portion Rd Ste A, Lake Ronkonkoma, NY 11779-4172

Other providers in Lake Ronkonkoma