Organization
GARY SHORE MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY J SHORE M.D. (PRESIDENT)
(516) 377-2820
Entity
Organization
Contact information
Practice address
31 MERRICK AVE, SUITE 230, MERRICK, NY 11566-3477
(516) 377-2820
(516) 378-2968
Mailing address
87 E LEXINGTON AVE, OCEANSIDE, NY 11572-5420
(516) 377-2820
(516) 378-2968
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
179490
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
179491N01
HIP
NY
01
—
DP304
OXFORD
—
Enumeration date
06/11/2009
Last updated
04/20/2010
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