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Organization
THE MEDICAL STATION OF NORTH SHORE PC
Active
Organization
THE MEDICAL STATION OF NORTH SHORE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE FELICIANO MD (OWNER)
(516) 759-5406
Entity
Organization
Contact information
Practice address
480 FOREST AVE, LOCUST VALLEY, NY 11560
(516) 759-5406
(516) 759-5537
Mailing address
480 FOREST AVE, LOCUST VALLEY, NY 11560-2151
(516) 759-5406
(516) 759-5537
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
243930
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5395P1
EMPIRE BLUE CROSS BLUE SHIELD
NY
Enumeration date
09/27/2017
Last updated
07/21/2022
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