Southside Hospital Emergency Department

NPI #1528025459 in Bay Shore, New York

Provider Information

NPI Number: 1528025459
Entity Type: Organization
Organization Name: Southside Hospital Emergency Department
Subpart: Yes (part of a larger organization)
Parent Organization: SOUTHSIDE HOSPITAL
Primary Specialty: Emergency Medicine
Enumeration Date: Apr 26, 2006
Last Updated: Oct 9, 2007

Practice Location

Address: 301 E MAIN ST
City: Bay Shore
State: New York
ZIP Code: 11706-8408
Phone: (631) 675-4149

Authorized Official

Name: MS. WINIFRED MACK
Title: CFO
Phone: (631) 968-9000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X
Pediatrics	208000000X
Internal Medicine	207R00000X
Emergency Medicine	207P00000X	Primary

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