Shore To Shore Medical Wellness PLLC
NPI 1679211965ActiveOrganization· Specialist· Port Jefferson Station, NY
Specialist in Port Jefferson Station, New York, registered in NPPES in May 2022. The authorized official on file is Gregory Brevetti, Owner.
Overview
| NPI | 1679211965 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 25, 2022 |
| Last updated in NPPES | Feb 17, 2023 |
| Certified by provider | Feb 17, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Specialist Primary | 174400000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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All 99 Specialist providers in Port Jefferson Station · All Specialist providers in New York