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

Varicose Vein Medical Office PC

Organization Phlebology Physician · NPI 1356618615

Varicose Vein Medical Office PC is a Phlebology Physician in Port Jefferson, New York. Licensed in New York. Registered with an NPI since 2011.

Licensed in
NY
In the registry since
2011
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

405 E Main St
Port Jefferson, NY 11777-1868
Phone: (631) 474-1414
Fax: (631) 474-2032
Show map & directions

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

Specialties & licences

Phlebology Physician (primary) Taxonomy 202K00000X · Licence 174810 (NY)

Record details

NPI number1356618615
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jerry Ninia — Owner · (631) 474-1414
NPI enumeratedNovember 30, 2011
Last updated in NPPESNovember 30, 2011
Mailing address405 E Main St, Port Jefferson, NY 11777-1868

Other providers in Port Jefferson