Organization
WELLCARE MEDICAL OF NORTH SHORE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVAN B SHAPIRO MD (OWNER)
(516) 208-7600
Entity
Organization
Contact information
Practice address
85 S OCEAN AVE, PATCHOGUE, NY 11772-3702
(631) 506-8907
(631) 506-8909
Mailing address
85 S OCEAN AVE, PATCHOGUE, NY 11772-3702
(631) 506-8907
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Enumeration date
07/26/2022
Last updated
12/08/2022
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