| North Shore Medical Group Pllc | |
|
311 Skyview Ter Syracuse NY 13219-2835 | |
| (315) 935-1154 | |
| (952) 209-2012 |
| Full Name | North Shore Medical Group Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 311 Skyview Ter, Syracuse, New York |
| Authorized Official Name and Position | Joshu Coppola (PA) |
| Authorized Official Contact | 3152896300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North Shore Medical Group Pllc 311 Skyview Ter Syracuse NY 13219-2835 Ph: (315) 935-1154 | North Shore Medical Group Pllc 311 Skyview Ter Syracuse NY 13219-2835 Ph: (315) 935-1154 |
| NPI Number | 1487252581 |
|---|---|
| Provider Enumeration Date | 10/12/2020 |
| Last Update Date | 05/16/2022 |
| Medicare PECOS PAC ID | 9436565975 |
|---|---|
| Medicare Enrollment ID | O20210309001165 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487252581 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Primary |
| 363AM0700X | Physician Assistant - Medical | (* (Not Available)) | Secondary |
| Provider Name | Alberto Saludes Del Pilar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851534465 PECOS PAC ID: 6204060296 Enrollment ID: I20131007000280 |
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