| South Shore Family Medical Associates, P.c. | |
|
271 Doughty Blvd Inwood NY 11096-2135 | |
| (516) 371-6884 | |
| (516) 371-6083 |
| Full Name | South Shore Family Medical Associates, P.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 271 Doughty Blvd, Inwood, New York |
| Authorized Official Name and Position | Allan Scott Detweiler (PRESIDENT) |
| Authorized Official Contact | 5163716884 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South Shore Family Medical Associates, P.c. 271 Doughty Blvd Inwood NY 11096-2135 Ph: (516) 371-6884 | South Shore Family Medical Associates, P.c. 271 Doughty Blvd Inwood NY 11096-2135 Ph: (516) 371-6884 |
| NPI Number | 1720122716 |
|---|---|
| Provider Enumeration Date | 02/16/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 5597803213 |
|---|---|
| Medicare Enrollment ID | O20091117000286 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720122716 | NPI | - | NPPES |
| 01824973 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 205232 (New York) | Primary |
| Provider Name | Allan S Detweiler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992706402 PECOS PAC ID: 6608856141 Enrollment ID: I20041108000731 |
| Provider Name | Marc Sherman |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1528097953 PECOS PAC ID: 7618924309 Enrollment ID: I20051109001148 |
| Provider Name | John D Bedell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528254570 PECOS PAC ID: 4688742950 Enrollment ID: I20081014000470 |
| Provider Name | Joseph Vitoulis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154402030 PECOS PAC ID: 1153475090 Enrollment ID: I20090812000448 |
| Provider Name | Andrew G Woolrich |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1619062940 PECOS PAC ID: 4082802335 Enrollment ID: I20101230000583 |
| Provider Name | Anjuli Sinha |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205231032 PECOS PAC ID: 1557616125 Enrollment ID: I20180622000604 |
| Provider Name | Jonathon Charles Wenke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124681242 PECOS PAC ID: 6709217730 Enrollment ID: I20200507001533 |
| Provider Name | Michael A Britton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255970901 PECOS PAC ID: 2365859048 Enrollment ID: I20210324002168 |
| Provider Name | Makeda Morris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992464861 PECOS PAC ID: 9739570680 Enrollment ID: I20220103001236 |
| Provider Name | Melissa Pierre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437818630 PECOS PAC ID: 6608261391 Enrollment ID: I20220316000321 |
| Provider Name | Dian S Dyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396328936 PECOS PAC ID: 3476949801 Enrollment ID: I20220411002288 |
| Provider Name | Lawrence Adam Schiffman |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1386622397 PECOS PAC ID: 0143120303 Enrollment ID: I20231019000287 |
| Provider Name | Rayven Mason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134908114 PECOS PAC ID: 1254778780 Enrollment ID: I20240320001506 |
| Provider Name | Marcie M Perboo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265293682 PECOS PAC ID: 5193244341 Enrollment ID: I20250521002183 |
Inwood Family Practice And Osteopathic Medicine P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 101 Doughty Blvd, Inwood, NY 11096 Phone: 516-239-2924 Fax: 516-239-1609 | |
Inwood Community Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 270 Lawrence Ave., Inwood, NY 11096 Phone: 516-571-7874 |