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General NPI Number Information
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NPI Number | 1114974094
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Entity Type | Organization
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Legal Business Name | NORTH SHORE INFECTIOUS DISEASES CONSULTANTS, PC
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Dates
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Enumeration Date | 05/27/2006
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Last Update Date | 04/05/2024
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Provider Practice Location Address
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Address Line | 2200 NORTHERN BLVD STE 205
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City | GREENVALE
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State | NY
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Zip | 11548-1220
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Country | US
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Telephone | 516-767-7771
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Fax | 516-767-7765
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Provider Business Mailing Address
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Address Line | 2200 NORTHERN BLVD STE 205
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City | GREENVALE
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State | NY
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Zip | 11548-1220
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Country | US
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Telephone | 516-767-7771
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Fax | 516-767-7765
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | ANGIE RODRIGUEZ
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Credential |
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Telephone | 516-767-7771
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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