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General NPI Number Information
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NPI Number | 1003024662
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Entity Type | Organization
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Legal Business Name | NORTH SHORE RADIOLOGY AT GLEN COVE PC
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 06/11/2008
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Provider Practice Location Address
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Address Line | 10 MEDICAL PLZ
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City | GLEN COVE
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State | NY
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Zip | 11542-2193
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Country | US
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Telephone | 516-674-0500
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Fax | 516-674-7912
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Provider Business Mailing Address
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Address Line | 972 BRUSH HOLLOW RD
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City | WESTBURY
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State | NY
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Zip | 11590-1740
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Country | US
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Telephone | 516-876-5555
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Fax | 516-876-1246
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Authorized Official
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Title or Position | CFO
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Name | ROBERT SHAPIRO
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Credential |
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Telephone | 516-465-3017
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085N0904X
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Taxonomy Name | Nuclear Radiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085B0100X
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Taxonomy Name | Body Imaging Physician
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License Number |
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License Number State |
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