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General NPI Number Information
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NPI Number | 1891901583
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Entity Type | Organization
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Legal Business Name | SOUTH NASSAU COMMUNITIES HOSPITAL-SURGICAL ONCOLOGY
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 02/29/2008
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Provider Practice Location Address
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Address Line | 1 HEALTHY WAY BREAST GYN CENTER
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City | OCEANSIDE
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State | NY
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Zip | 11572-1551
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Country | US
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Telephone | 516-632-3573
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Fax |
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Provider Business Mailing Address
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Address Line | 1 HEALTHY WAY BREAST GYN CENTER
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City | OCEANSIDE
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State | NY
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Zip | 11572-1551
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Country | US
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Telephone | 516-632-3573
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Fax |
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Authorized Official
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Title or Position | VICE-PRESIDENT -FINANCE
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Name | MR. JOSEPH WISNOSKI
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Credential |
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Telephone | 516-632-3681
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 200879
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License Number State | NY
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