Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Lake Family Medical Practice PC

Organization Family Medicine Physician · NPI 1639923675

Lake Family Medical Practice PC provides Family Medicine Physician services 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

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