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Organization
NORTH SHORE MEDICAL PLLC
Active
Organization
NORTH SHORE MEDICAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARVIN BASE M.D. (DIRECTOR)
(718) 806-1434
Entity
Organization
Contact information
Practice address
9308 QUEENS BLVD # 1B1C, REGO PARK, NY 11374-1135
(718) 806-1434
(718) 806-1435
Mailing address
9308 QUEENS BLVD # 1B1C, REGO PARK, NY 11374-1135
(718) 806-1434
(718) 806-1435
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
187770
NY
Other
Enumeration date
10/12/2012
Last updated
12/11/2024
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