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General NPI Number Information
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NPI Number | 1528028917
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Entity Type | Organization
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Legal Business Name | NORTH SHORE MEDICAL SPECIALTIES GROUP PC
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Dates
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Enumeration Date | 03/28/2006
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Last Update Date | 12/27/2012
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Provider Practice Location Address
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Address Line | ONE HOLLOW LANE SUITE 312 NORTH SHORE MEDICAL SPECIALTIES GROUP PC
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City | LAKE SUCCESS
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State | NY
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Zip | 11042
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Country | US
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Telephone | 516-487-1414
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Fax | 516-487-0576
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Provider Business Mailing Address
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Address Line | ONE HOLLOW LANE SUITE 312 NORTH SHORE MEDICAL SPECIALTIES GROUP PC
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City | LAKE SUCCESS
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State | NY
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Zip | 11042
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Country | US
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Telephone | 516-487-1414
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Fax | 516-487-0576
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Authorized Official
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Title or Position | PHYSICIAN PRESIDENT
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Name | DR. BARTON E COHEN
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Credential | MD
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Telephone | 516-487-1414
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207UN0901X
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Taxonomy Name | Nuclear Cardiology Physician
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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