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General NPI Number Information
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NPI Number | 1497971048
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Entity Type | Organization
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Legal Business Name | NORTH SHORE PAIN MANAGEMENT P.C.
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7 HIGH ST SUITE 305
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City | HUNTINGTON
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State | NY
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Zip | 11743-7605
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Country | US
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Telephone | 631-673-6969
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Fax | 631-673-2992
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Provider Business Mailing Address
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Address Line | 7 HIGH ST SUITE 305
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City | HUNTINGTON
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State | NY
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Zip | 11743-7605
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Country | US
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Telephone | 631-673-6969
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Fax | 631-673-2992
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GARY TOPPER
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Credential | M.D.
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Telephone | 631-673-6969
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 130080-4
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License Number State | NY
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