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General NPI Number Information
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NPI Number | 1477156958
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Entity Type | Organization
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Legal Business Name | PARTNERS IN SURGICAL SERVICES
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Dates
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Enumeration Date | 11/18/2020
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Last Update Date | 11/18/2020
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Provider Practice Location Address
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Address Line | 1300 ROANOKE AVE
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City | RIVERHEAD
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State | NY
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Zip | 11901-2031
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Country | US
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Telephone | 516-625-1014
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Fax | 516-414-4011
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Provider Business Mailing Address
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Address Line | 112 MADISON AVE
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-5229
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Country | US
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Telephone | 516-625-1014
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Fax | 516-414-4011
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | JOSEPH M SHARKEY
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Credential | PA
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Telephone | 516-625-1014
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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