Organization
SOUTH SHORE NEUROLOGIC ASSOCIATES, PC
Active
Parent organization
SOUTH SHORE NEUROLOGIC ASSOCIATES PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTH SHORE NEUROLOGIC ASSOCIATES PC
Authorized official
MRS. ANGELA DERITIS (BILLING MANAGER)
(631) 758-4444
Entity
Organization
Contact information
Practice address
77 MEDFORD AVENUE, ROUTE 112, PATCHOGUE, NY 11772
(631) 758-1910
(631) 730-3467
Mailing address
77 MEDFORD AVENUE, ROUTE 112, PATCHOGUE, NY 11772
(631) 758-1910
(631) 730-3467
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1313140002
NY
Other
Enumeration date
02/17/2011
Last updated
05/04/2011
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