Organization
SOUTHSIDE HOSPITAL DEPARTMENT OF CARDIOLOGY
Active
Parent organization
SOUTHSIDE HOSPITAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHSIDE HOSPITAL
Authorized official
MS. WINIFRED B. MACK (EXECUTIVE DIRECTOR)
(631) 968-3000
Entity
Organization
Contact information
Practice address
301 E MAIN ST, BAY SHORE, NY 11706-8408
(631) 968-3000
Mailing address
301 E MAIN ST, BAY SHORE, NY 11706-8408
(631) 968-3000
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Enumeration date
02/22/2007
Last updated
02/07/2008
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