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Organization
NORTH SHORE HEMATOLOGY ONCOLOGY ASSOCIATES
Active
Organization
NORTH SHORE HEMATOLOGY ONCOLOGY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD T SAMUEL MD (PROVIDER)
(631) 751-3000
Entity
Organization
Contact information
Practice address
48 ROUTE 25A, SUITE 209, SMITHTOWN, NY 11787-1431
(631) 979-6501
Mailing address
235 N BELLE MEAD RD, EAST SETAUKET, NY 11733-3456
(631) 751-3000
(631) 941-2700
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00679947
—
NY
01
—
CC5178
RR MEDICARE
NY
Enumeration date
06/29/2007
Last updated
12/06/2007
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