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Organization
NORTH SHORE MEDICAL GROUP OF THE MOUNT SINAI SCHOOL OF MEDICINE
Active
Organization
NORTH SHORE MEDICAL GROUP OF THE MOUNT SINAI SCHOOL OF MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JANET STREET (PRACTICE ADMINISTRATOR)
(631) 351-3703
Entity
Organization
Contact information
Practice address
59 SOUTHERN BLVD, NESCONSET, NY 11767-1090
(631) 659-1700
(631) 659-1750
Mailing address
59 SOUTHERN BLVD, NESCONSET, NY 11767-1090
(631) 659-1700
(631) 659-1750
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
—
NULL
207RC0000X
Cardiovascular Disease Physician
—
—
207RG0100X
Gastroenterology Physician
Primary
—
NULL
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Enumeration date
04/20/2009
Last updated
11/08/2012
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