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Organization
SOUTH NASSAU FAMILY MEDICINE PC
Active
Organization
SOUTH NASSAU FAMILY MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT IPPOLITO M.D. (CHAIRMAN)
(516) 255-8400
Entity
Organization
Contact information
Practice address
196 MERRICK RD, OCEANSIDE, NY 11572-1420
(516) 255-8400
(516) 255-8453
Mailing address
1 HEALTHY WAY, ATTN: PHYSICIAN BILLING DEPT, OCEANSIDE, NY 11572-1551
(516) 255-1600
(516) 255-4672
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02156889
—
NY
Enumeration date
09/16/2005
Last updated
08/22/2020
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