South Shore Physicians, P.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

162022 Issued in NY

Legal business name

SOUTH SHORE PHYSICIANS, P.C.

Practice address

3589 Hylan Blvd
Staten Island, NY 10308-3513

Phone

(718) 966-3700

NPI assigned

Jul 3, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Paul C Gazzara, M.D.NPI 1366417677

Title

Administrator

Phone

(718) 966-3700

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Paul Carmine Gazzara, M.D.

  • Addiction Medicine (Internal Medicine) Physician
  • Staten Island, NY
  • NPI 1366417677
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415145600000",
    "number": "1093745333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3589 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103083513",
            "telephone_number": "718-966-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3589 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103083513",
            "telephone_number": "718-966-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SHORE PHYSICIANS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "last_updated": "2014-11-05",
        "status": "A",
        "authorized_official_last_name": "GAZZARA",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "718-966-3700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "162022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Beach Psychiatric Center
• South Beach Psychiatric Center
• South Shore Advanced Physical Therapy PC
• South Shore Chiropractic PC
• South Shore Chiropractic, PLLC
• South Shore S I Physical Therapy PC
• South Shore Si Physical Therapy PC
• Samantha Taylor Southard, LMHC
• Southshore Pharmacy Corp.
• Jamie Souza-Page, OTR/L

• Internal Medicine Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.