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General NPI Number Information
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NPI Number | 1154675395
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Entity Type | Organization
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Legal Business Name | NORTH SHORE DIAGNOSTICS
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Dates
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Enumeration Date | 11/08/2012
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Last Update Date | 11/08/2012
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Provider Practice Location Address
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Address Line | 175 JERICHO TPKE SUITE 102
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City | SYOSSET
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State | NY
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Zip | 11791-4532
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Country | US
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Telephone | 516-364-3393
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Fax | 516-364-3485
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Provider Business Mailing Address
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Address Line | 175 JERICHO TPKE SUITE 102
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City | SYOSSET
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State | NY
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Zip | 11791-4532
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STEVEN SCHNEIDER
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Credential |
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Telephone | 516-364-3393
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | X2544
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License Number State | NY
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