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General NPI Number Information
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NPI Number | 1982749446
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Entity Type | Organization
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Legal Business Name | INTERNAL MEDICINE OF NORTH SHORE, PC
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 09/07/2014
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Provider Practice Location Address
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Address Line | 175 JERICHO TPKE SUITE 302
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City | SYOSSET
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State | NY
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Zip | 11791-4532
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Country | US
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Telephone | 516-367-6230
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Fax |
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Provider Business Mailing Address
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Address Line | 175 JERICHO TPKE SUITE 302
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City | SYOSSET
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State | NY
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Zip | 11791-4532
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Country | US
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Telephone | 516-367-6230
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANNIE HU
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Credential | M.D.
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Telephone | 516-367-6230
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 230376
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License Number State | NY
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