Wound Treatment Medical Associates of the South Shore

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

137566 Issued in NY

Legal business name

WOUND TREATMENT MEDICAL ASSOCIATES OF THE SOUTH SHORE

Practice address

900 Franklin Avenue
Wound Treatment Medical Associates of the South Shore
Valley Stream, NY 11580

Phone

(516) 256-6576

Fax

(516) 256-6888

NPI assigned

Sep 28, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Liz Vandewater

Title

Office Manager

Phone

(516) 256-6576

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586908800000",
    "number": "1740372903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 FRANKLIN AVENUE",
            "address_2": "WOUND TREATMENT MEDICAL ASSOCIATES OF THE SOUTH SHORE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "11580",
            "telephone_number": "516-256-6576",
            "fax_number": "516-256-6888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 FRANKLIN AVENUE",
            "address_2": "WOUND TREATMENT MEDICAL ASSOCIATES OF THE SOUTH SHORE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "11580",
            "telephone_number": "516-256-6576",
            "fax_number": "516-256-6888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOUND TREATMENT MEDICAL ASSOCIATES OF THE SOUTH SHORE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2020-04-15",
        "certification_date": "2020-04-15",
        "status": "A",
        "authorized_official_last_name": "VANDEWATER",
        "authorized_official_first_name": "LIZ",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "516-256-6576",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NY",
            "license": "137566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Winthrop Community Medical Affiliates
• Winthrop Community Medical Affiliates, PC
• Sheila Wojciechowski
• Marissa Wong
• Stephanie Wong
• Andrea Wright, LMSW
• Rachel Naomi Wyner, PHD
• Jenny Xiao, DDS
• Karen Yager, SPEECH/LANGUAGE THER
• Diana Yagudayeva, M.S. ED

• Clinic/Center in Valley Stream, NY
• Providers in Valley Stream, NY by specialty
• Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2020; 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.