| NPI | 1255866372 |
|---|---|
| Doing Business As | SOUTH SHORE VEIN AND IMAGE-GUIDED MEDICINE |
| Entity Type | Organization |
| Authorized Contact | DAVID T JACOBS Owner 516-865-1234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 202K00000X |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 257302-1) |
| Enumeration Date | 2017-04-26 |
| Last Update Date | 2020-12-31 |