Provider Demographics
NPI:1528784634
Name:NORTH SHORE HEMATOLOGY ONCOLOGY ASSOCIATES PC
Entity type:Organization
Organization Name:NORTH SHORE HEMATOLOGY ONCOLOGY ASSOCIATES PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DANDRAIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-751-3000
Mailing Address - Street 1:1 RESEARCH RD
Mailing Address - Street 2:
Mailing Address - City:RIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:11961-2701
Mailing Address - Country:US
Mailing Address - Phone:631-751-3000
Mailing Address - Fax:
Practice Address - Street 1:2236 NOSTRAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-3037
Practice Address - Country:US
Practice Address - Phone:347-418-4437
Practice Address - Fax:631-751-0506
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTH SHORE HEMATOLOGY/ONCOLOGY ASSOCIATES PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-10-19
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No261QX0200XAmbulatory Health Care FacilitiesClinic/CenterOncology
No261QX0203XAmbulatory Health Care FacilitiesClinic/CenterOncology, Radiation