Southside Hospital Department of Cardiology

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

SOUTHSIDE HOSPITAL DEPARTMENT OF CARDIOLOGY

Practice address

301 E Main St
Bay Shore, NY 11706-8408

Phone

(631) 968-3000

NPI assigned

Feb 22, 2007

Last updated

Feb 7, 2008By the provider in NPPES

Organization subpart

Yes

Parent organization

SOUTHSIDE HOSPITALAs reported in NPPES

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

Authorized official

Name

Ms. Winifred B. Mack

Title

Executive Director

Phone

(631) 968-3000

Specialties & licenses 1

Addresses

Part of

Southside Hospital HHA

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202342400000",
    "number": "1649305228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 E MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068408",
            "telephone_number": "631-968-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068408",
            "telephone_number": "631-968-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSIDE HOSPITAL DEPARTMENT OF CARDIOLOGY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHSIDE HOSPITAL",
        "enumeration_date": "2007-02-22",
        "last_updated": "2008-02-07",
        "status": "A",
        "authorized_official_last_name": "MACK",
        "authorized_official_first_name": "WINIFRED",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "631-968-3000",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Shore University Hospital
• South Shore University Hospital
• Southshore Medical Practice Management, Inc
• Southside Hospital
• Southside Hospital
• Southside Hospital Department of Neurology
• Southside Hospital Department of Pathology
• Southside Hospital Department of Psychiatry
• Southside Hospital Emergency Department
• Southside Hospital Faculty Practice

• Cardiovascular Disease Physician in Bay Shore, NY
• Providers in Bay Shore, NY by specialty
• Cardiovascular Disease Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2008; 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.