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Organization

NORTH SHORE MEDICAL GROUP OF MT SINAI SCHOOL OF MEDICINE

Active
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Organization

NORTH SHORE MEDICAL GROUP OF MT SINAI SCHOOL OF MEDICINE

Active
Other names
North Shore Medical Group
Organization subpart
No

Provider details

NPI number
Authorized official
JANET STREET (ADMINISTRATOR)
(631) 351-3703
Entity
Organization

Contact information

Practice address
201 PORTION RD, SUITE C, LAKE RONKONKOMA, NY 11779-4172
(631) 585-5959
Mailing address
201 PORTION RD, SUITE C, LAKE RONKONKOMA, NY 11779-4172
(631) 585-5959

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—

Other

Enumeration date
08/13/2010
Last updated
08/13/2010
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