Organization
N. S. SO ISLAND DIAG GRP
Active
Parent organization
SOUTH ISLAND MEDICAL ASSOCIATES P.C.
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTH ISLAND MEDICAL ASSOCIATES P.C.
Authorized official
MRS. NORMA L BUHRTS (VP)
(239) 210-0132
Entity
Organization
Contact information
Practice address
9009 ROCKAWAY BCH BLVD, ROCKAWAY BEACH, NY 11693-1531
(718) 474-9631
Mailing address
PO BOX 549, CEDARHURST, NY 11516-0549
(718) 471-5400
(718) 382-5400
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
33D0875629
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000142305
AMERICHOICE
NY
01
—
113493693
AFFINITY
NY
01
—
G560950
OXFORD
NY
Enumeration date
11/28/2007
Last updated
05/29/2008
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