Organization
VETERANS ADMINISTRATION HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. XIYUN SHAO M.D. (ATTENDING PHYSICIAN)
(917) 940-8711
Entity
Organization
Contact information
Practice address
79 MIDDLEVILLE RD, NORTHPORT, NY 11768-2200
(631) 261-4363
Mailing address
15 JEAN PL, SYOSSET, NY 11791-5914
(516) 558-7900
Taxonomy
Speciality
Code
Description
License number
State
261QA0005X
Ambulatory Family Planning Facility
Primary
245201
NY
261QA0600X
Adult Day Care Clinic/Center
245201
NY
275N00000X
Medicare Defined Swing Bed Hospital Unit
245201
NY
Other
Enumeration date
09/07/2007
Last updated
09/07/2007
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