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General NPI Number Information
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NPI Number | 1407932684
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Entity Type | Organization
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Legal Business Name | BAY SHORE OB GYN GROUP PC
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Dates
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Enumeration Date | 10/31/2006
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Last Update Date | 06/10/2008
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Provider Practice Location Address
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Address Line | 41 BRENTWOOD RD
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City | BAY SHORE
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State | NY
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Zip | 11706-6923
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Country | US
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Telephone | 631-665-0808
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Fax | 631-665-0816
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Provider Business Mailing Address
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Address Line | 41 BRENTWOOD RD
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City | BAY SHORE
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State | NY
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Zip | 11706-6923
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Country | US
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Telephone | 631-665-0808
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Fax | 631-665-0816
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT JOHN LIPARI
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Credential | MD
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Telephone | 631-665-0808
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 136230
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License Number State | NY
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