South Shore Faculty Medical Affiliates, University Faculty Practice Co

NPI #1720824840 in Bay Shore, New York

Provider Information

NPI Number: 1720824840
Entity Type: Organization
Organization Name: South Shore Faculty Medical Affiliates, University Faculty Practice Co
Primary Specialty: Physician Assistant
Enumeration Date: Jul 8, 2024
Last Updated: Jul 8, 2024

Practice Location

Address: 301 E MAIN ST
City: Bay Shore
State: New York
ZIP Code: 11706-8408
Phone: (631) 968-3000

Authorized Official

Name: VICTORIA A GANGALE, PA
Title: PHYSICIAN ASSISTANT
Phone: (631) 968-3000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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