Organization
SOUTH SHORE CARDIOVASCULAR MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN A RUISI MD (PRESIDENT)
(631) 264-2424
Entity
Organization
Contact information
Practice address
137 BROADWAY, SUITE A, AMITYVILLE, NY 11701-2742
(631) 264-2424
(631) 264-7881
Mailing address
15 SKIPPER DR, WEST ISLIP, NY 11795-5029
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
161768-1
NY
Other
Enumeration date
07/13/2006
Last updated
08/22/2020
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