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General NPI Number Information
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NPI Number | 1023102696
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Entity Type | Organization
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Legal Business Name | BAY SHORE FAMILY MEDICINE ASSOCIATES, P.C.
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 02/27/2009
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Provider Practice Location Address
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Address Line | 19 EAST MAIN ST SUITE 8
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City | BAY SHORE
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State | NY
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Zip | 11706
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Country | US
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Telephone | 631-665-0760
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Fax | 631-665-1886
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Provider Business Mailing Address
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Address Line | 19 EAST MAIN ST SUITE 8
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City | BAY SHORE
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State | NY
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Zip | 11706
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Country | US
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Telephone | 631-665-0760
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Fax | 631-665-1886
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Authorized Official
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Title or Position | PRESIDENT
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Name | STEVEN E KLEIN
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Credential | M.D.
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Telephone | 631-665-8515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 162359
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 221368
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License Number State | NY
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