South Shore Medical Services PLLC
Physician Assistant, Medical in West Islip, NY. Organization (NPI-2).
NPI number1164087375
StatusActive
Last updated in NPPESMay 2, 2019
Details
- NPI
- 1164087375
- Entity type
- Organization (NPI-2)
- Legal business name
- South Shore Medical Services PLLC
- Organization subpart
- No
- Enumeration date
- May 2, 2019
- Last updated
- May 2, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | – | – | Yes |
Practice location
1175 Montauk KwySuite 6
West Islip, NY 11795
Phone 631-422-5371 · Fax 631-893-8012
Mailing address
1175 Montauk KwySuite 6
West Islip, NY 11795
Phone 631-422-5371 · Fax 631-893-8012
Authorized official
Salvatore Palumbo
Owner
6314225371
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