# FAMILY MEDICAL CARE OF BAYSHORE, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487807061
- **Authorized official:** CARLA CANAVIRE-WEBER D.O (OWNER)
- **Authorized official phone:** (631) 328-5560

## Contact information

- **Practice address:** 1745 UNION BLVD, BAY SHORE, NY 11706-7952
- **Practice address phone:** (631) 328-5560
- **Practice address fax:** (516) 328-5599
- **Mailing address:** 1745 UNION BLVD, BAY SHORE, NY 11706-7952
- **Mailing address phone:** (631) 328-5560
- **Mailing address fax:** (516) 328-5599

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 210883 | NY | Yes |

## Other

- **Enumeration date:** 10/28/2008
- **Last updated:** 10/28/2008