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General NPI Number Information
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NPI Number | 1700995602
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Entity Type | Organization
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Legal Business Name | SOUTH SHORE EYE CARE, LLP
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2185 WANTAGH AVE
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City | WANTAGH
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State | NY
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Zip | 11793-3917
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Country | US
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Telephone | 516-785-3900
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Fax | 516-783-0033
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Provider Business Mailing Address
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Address Line | 2185 WANTAGH AVE
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City | WANTAGH
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State | NY
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Zip | 11793-3917
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Country | US
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Telephone | 516-785-3900
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Fax | 516-783-0033
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Authorized Official
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Title or Position | SENIOR PARTNER
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Name | MARK STEIN
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Credential | M.D.
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Telephone | 516-785-3900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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