South Shore Womens Care PLLC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

SOUTH SHORE WOMENS CARE PLLC

Practice address

750 Montauk Hwy
West Islip, NY 11795-4411

Phone

(347) 523-0054

NPI assigned

Jun 7, 2021

Last updated

Jun 7, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Larissa Fomitcheva, MDNPI 1780695718

Title

President

Phone

(347) 523-0054

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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.

• Larissa Fomitcheva, M.D.

  • Obstetrics & Gynecology Physician
  • Lindenhurst, NY
  • NPI 1780695718
  NPD Authorized official

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

{
    "created_epoch": "1623024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623024000000",
    "number": "1174190326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 COBBLERS LN",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117465020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 MONTAUK HWY",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954411",
            "telephone_number": "347-523-0054"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "57 W Sunrise Hwy",
            "address_purpose": "LOCATION",
            "city": "Lindenhurst",
            "state": "NY",
            "postal_code": "117572421",
            "country_code": "US",
            "telephone_number": "347-523-0054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTH SHORE WOMENS CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-07",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A",
        "authorized_official_last_name": "FOMITCHEVA",
        "authorized_official_first_name": "LARISSA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "347-523-0054",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02834742",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• South Bay Urologic Associates, P.C.
• South Main Chiropractic,P.C.
• South Shore Atlantic Physical Therapy PLLC
• South Shore Medical Services PLLC
• South Shore Orthopaedic Associates
• South Suffolk Orthopedic Surgery and Sports Medicine P.C
• Southbay Cardiovascular Assoc PC
• Kristen Spargo, OT
• Arthur Michael Speziale Jr., DO
• Andrew Spielman

• Obstetrics & Gynecology Physician in West Islip, NY
• Providers in West Islip, NY by specialty
• Obstetrics & Gynecology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; 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.