| NPI | 1902918899 |
|---|---|
| Doing Business As | NORTH SHORE MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | JANET STREET Administrator 631-351-3703 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology Gynecology |
| 2085B0100X Radiology Body Imaging | |
| 2085U0001X Radiology Diagnostic Ultrasound | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-08-22 |