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NPI Code Detail

MEDICARE: SHORE MEDICAL TREATMENT PLLC

MEDICARE: SHORE MEDICAL TREATMENT PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist

General Provider Information

NPI Number : 1457016669
Entity Type Code : Organization
Provider Name (Legal Business Name) : SHORE MEDICAL TREATMENT PLLC
Provider Business Mailing Address
First Line : 244 MADISON AVE # 165
Second Line :
City : NEW YORK
State : NY
Zip : 10016-2817
Country : US
Telephone Number : 631-450-3772
Fax Number : 212-561-5530
Provider Business Practice Location Address
First Line : 350 JERICHO TPKE STE 310
Second Line :
City : JERICHO
State : NY
Zip : 11753-1317
Country : US
Telephone Number : 631-450-3772
Fax Number : 212-561-5530
Authorized Official
Title or Position : OWNER
Name : DR. MICHAEL NGUYEN
Credential : MD
Telephone Number : 332-282-5622
Provider Enumeration Date : 11/02/2021
Last Update Date : 06/03/2026

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Directions to “SHORE MEDICAL TREATMENT PLLC ” Practice Location

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