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General NPI Number Information
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NPI Number | 1447224282
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Entity Type | Organization
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Legal Business Name | SOUND SHORE PROVIDER SERVICES
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Dates
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Enumeration Date | 02/16/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 16 GUION PL
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City | NEW ROCHELLE
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State | NY
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Zip | 10801-5503
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Country | US
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Telephone | 914-637-1357
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Fax | 914-637-1489
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Provider Business Mailing Address
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Address Line | PO BOX 1019
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City | SPRING VALLEY
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State | NY
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Zip | 10977-0819
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Country | US
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Telephone | 914-637-1357
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Fax | 914-637-1489
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Authorized Official
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Title or Position | CFO
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Name | MR. DOUGLAS LANDY
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Credential |
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Telephone | 914-637-1357
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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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 | 2084P0800X
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Taxonomy Name | Psychiatry 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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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