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General NPI Number Information
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NPI Number | 1710184999
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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 | 06/29/2007
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Last Update Date | 09/19/2023
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Provider Practice Location Address
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Address Line | 285 SILLS RD BLDG 1
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City | EAST PATCHOGUE
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State | NY
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Zip | 11772-4869
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Country | US
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Telephone | 631-654-8200
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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 | DIRECTOR OF CREDENTIALING
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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 | 174400000X
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Taxonomy Name | Specialist
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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