Organization
SOUTHSIDE HOSPITAL DEPARTMENT OF PATHOLOGY
Active
Parent organization
SOUTHSIDE HOSPITAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHSIDE HOSPITAL
Authorized official
MS. WINIFRED MACK (CFO)
(631) 968-9000
Entity
Organization
Contact information
Practice address
301 E MAIN ST, BAY SHORE, NY 11706-8408
(631) 675-4149
Mailing address
301 E MAIN ST, BAY SHORE, NY 11706-8408
(631) 675-4149
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Enumeration date
04/24/2006
Last updated
10/09/2007
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