Blue Coast Medical Wellness, Pllc

NPI #1710760376 in Aquebogue, New York

Provider Information

NPI Number: 1710760376
Entity Type: Organization
Organization Name: Blue Coast Medical Wellness, Pllc
Primary Specialty: Specialist
Enumeration Date: Aug 17, 2023
Last Updated: Aug 17, 2023

Practice Location

Address: 740 MAIN ROAD
City: Aquebogue
State: New York
ZIP Code: 11931
Phone: (631) 343-4184

Authorized Official

Name: GREGORY BREVETTI, MD
Title: OWNER/PROVIDER
Phone: (917) 575-8907

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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