Provider Demographics
NPI:1982376216
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 OF CREDENTIALING
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 1:1500 ROUTE 112 BLDG 4
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11776-8055
Mailing Address - Country:US
Mailing Address - Phone:163-175-1300
Mailing Address - Fax:631-751-0506
Practice Address - Street 1:1158 BROADWAY
Practice Address - Street 2:
Practice Address - City:HEWLETT
Practice Address - State:NY
Practice Address - Zip Code:11557-2302
Practice Address - Country:US
Practice Address - Phone:631-751-3000
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:2021-10-05
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Multi-Specialty