| North Shore Digestive Medicine Pc | |
|
50 Route 111 Suite 302 Smithtown NY 11787-3738 | |
| (516) 488-9427 | |
| (800) 557-3140 |
| Full Name | North Shore Digestive Medicine Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 50 Route 111, Smithtown, New York |
| Authorized Official Name and Position | Farzad Forohar (MEMBER) |
| Authorized Official Contact | 5164889427 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North Shore Digestive Medicine Pc 50 Route 111 Suite 302 Smithtown NY 11787-3738 Ph: (516) 488-9427 | North Shore Digestive Medicine Pc 50 Route 111 Suite 302 Smithtown NY 11787-3738 Ph: (516) 488-9427 |
| NPI Number | 1407114960 |
|---|---|
| Provider Enumeration Date | 05/02/2012 |
| Last Update Date | 05/02/2012 |
| Medicare PECOS PAC ID | 2860642592 |
|---|---|
| Medicare Enrollment ID | O20121015000668 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407114960 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | James Missig |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1093819484 PECOS PAC ID: 2668386285 Enrollment ID: I20031118000487 |
| Provider Name | Nancy Johnstone-bradshaw |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1699776278 PECOS PAC ID: 7113816885 Enrollment ID: I20040311000749 |
| Provider Name | Steve Xiang-hui Shay |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1548203953 PECOS PAC ID: 6103715040 Enrollment ID: I20040819000011 |
| Provider Name | Hengameh Ardalan |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1861428526 PECOS PAC ID: 1254307002 Enrollment ID: I20040903000013 |
| Provider Name | Deye Wei |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1366412777 PECOS PAC ID: 4486676566 Enrollment ID: I20060104000103 |
| Provider Name | Fanyi Kong |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1528131596 PECOS PAC ID: 2062508468 Enrollment ID: I20071017000228 |
| Provider Name | Steven Teplitz |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1003815960 PECOS PAC ID: 5193813392 Enrollment ID: I20071126000288 |
| Provider Name | Mudnia Sheikh |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1164608998 PECOS PAC ID: 2567541253 Enrollment ID: I20080506000794 |
| Provider Name | Diane F Lam |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1982845038 PECOS PAC ID: 7618010588 Enrollment ID: I20100202000041 |
| Provider Name | Linxing Liu |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1922086255 PECOS PAC ID: 9436287752 Enrollment ID: I20100507000000 |
| Provider Name | Farzad Forohar |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1285603746 PECOS PAC ID: 8224227293 Enrollment ID: I20110106000041 |
| Provider Name | Michael Reens |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1639457286 PECOS PAC ID: 3173797289 Enrollment ID: I20111129000142 |
| Provider Name | Gang He |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1164613667 PECOS PAC ID: 5294821914 Enrollment ID: I20131204000479 |
| Provider Name | William E Higgins |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1437581931 PECOS PAC ID: 5698903771 Enrollment ID: I20140319000113 |
| Provider Name | Valerie Birmingham |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1881211266 PECOS PAC ID: 8426436817 Enrollment ID: I20220525001029 |
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