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General NPI Number Information
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NPI Number | 1619797594
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Entity Type | Organization
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Legal Business Name | NORTH SHORE HEMATOLOGY ONCOLOGY ASSOCIATES PC
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Dates
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Enumeration Date | 10/15/2024
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 1055 STEWART AVE
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City | BETHPAGE
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State | NY
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Zip | 11714-3596
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Country | US
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Telephone | 718-732-4049
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Fax |
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Provider Business Mailing Address
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Address Line | 1 RESEARCH RD
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City | RIDGE
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State | NY
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Zip | 11961-2701
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Country | US
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Telephone | 631-751-3000
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Fax |
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Authorized Official
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Title or Position | SENOR DIRECTOR
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Name | PATRICIA DANDRAIA
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Credential |
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Telephone | 631-751-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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