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General NPI Number Information
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NPI Number | 1033778824
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Entity Type | Organization
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Legal Business Name | SOUTH SHORE MEDICAL CENTER, INC
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Dates
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Enumeration Date | 06/06/2019
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Last Update Date | 01/23/2024
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Provider Practice Location Address
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Address Line | 143 LONGWATER DR
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City | NORWELL
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State | MA
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Zip | 02061-1683
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Country | US
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Telephone | 781-878-5200
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Fax |
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Provider Business Mailing Address
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Address Line | 141 LONGWATER DR
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City | NORWELL
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State | MA
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Zip | 02061-1632
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Country | US
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Telephone | 781-792-4136
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING SUPERVISOR
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Name | JACLYN VALANZOLA
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Credential |
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Telephone | 781-681-0384
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 207KA0200X
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Taxonomy Name | Allergy Physician
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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