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NPI Code Detail

MEDICARE: NORTH SHORE TMS

MEDICARE: NORTH SHORE TMS
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
12084P0800XPsychiatry Physician242634NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11912079302OTHERNPI NUMBER

General Provider Information

NPI Number : 1467967356
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTH SHORE TMS
Provider Business Mailing Address
First Line : 75 PROSPECT ST STE 105
Second Line :
City : HUNTINGTON
State : NY
Zip : 11743-3310
Country : US
Telephone Number : 631-923-0006
Fax Number : 631-498-0189
Provider Business Practice Location Address
First Line : 75 PROSPECT ST STE 105
Second Line :
City : HUNTINGTON
State : NY
Zip : 11743-3310
Country : US
Telephone Number : 631-923-0006
Fax Number : 631-498-0189
Authorized Official
Title or Position : MEDICAL DIRECTOR, NORTH SHORE TMS
Name : DR. ANDREA CARLSEN
Credential : MD
Telephone Number : 631-923-0006
Provider Enumeration Date : 12/13/2017
Last Update Date : 12/13/2017

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Directions to “NORTH SHORE TMS ” Practice Location

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