| South Shore Neurologic Associates P.c. | |
|
712 Main St Islip NY 11751-3620 | |
| (631) 666-3939 | |
| (631) 666-3994 |
| Full Name | South Shore Neurologic Associates P.c. |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 712 Main St, Islip, New York |
| Authorized Official Name and Position | Angela Deritis (CERTIFIED MEDICAL MANAGER) |
| Authorized Official Contact | 6316663939 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Shore Neurologic Associates P.c. 712 Main St Islip NY 11751-3620 Ph: (631) 666-3939 | South Shore Neurologic Associates P.c. 712 Main St Islip NY 11751-3620 Ph: (631) 666-3939 |
| NPI Number | 1417905969 |
|---|---|
| Provider Enumeration Date | 05/05/2006 |
| Last Update Date | 11/08/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417905969 | NPI | - | NPPES |
| 01259347 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
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