| South Nassau Family Medicine Pc | |
|
196 Merrick Rd Oceanside NY 11572-1420 | |
| (516) 255-8400 | |
| (516) 255-8453 |
| Full Name | South Nassau Family Medicine Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 196 Merrick Rd, Oceanside, New York |
| Authorized Official Name and Position | Scott Ippolito (CHAIRMAN) |
| Authorized Official Contact | 5162558400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Nassau Family Medicine Pc 1 Healthy Way Attn: Physician Billing Dept Oceanside NY 11572-1551 Ph: (516) 255-1600 | South Nassau Family Medicine Pc 196 Merrick Rd Oceanside NY 11572-1420 Ph: (516) 255-8400 |
| NPI Number | 1902891781 |
|---|---|
| Provider Enumeration Date | 09/16/2005 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902891781 | NPI | - | NPPES |
| 02156889 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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