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General NPI Number Information
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NPI Number | 1982376216
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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 | 10/05/2021
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 1158 BROADWAY
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City | HEWLETT
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State | NY
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Zip | 11557-2302
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Country | US
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Telephone | 631-751-3000
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Fax | 631-751-0506
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Provider Business Mailing Address
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Address Line | 1500 ROUTE 112 BLDG 4
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City | PORT JEFFERSON STATION
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State | NY
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Zip | 11776-8055
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Country | US
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Telephone | 163-175-1300
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Fax | 631-751-0506
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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 | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound 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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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