Southside Hospital Emergency Department

LBN: Southside Hospital Emergency Department
Southside Hospital Emergency Department is an health care organization with primary practice located at 301 E Main St , Bay Shore NY 11706-8408. The organization recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatrics, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Allopathic & Osteopathic Physicians / Emergency Medicine is the primary health care specialty. Southside Hospital Emergency Department can be contacted via phone (631) 675-4149, or through Mack, Winifred via phone (631) 968-9000.

Contact Information

Primary practice address
301 E Main St Bay Shore NY 11706-8408
Phone: (631) 675-4149
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Mack, Winifred
Phone: (631) 968-9000

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X
Allopathic & Osteopathic Physicians / Pediatrics 208000000X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X

Profile Details

NPI number 1528025459
LBN Legal business name Southside Hospital Emergency Department
DBA Doing business as
Authorized official Mack, Winifred
Entity Organization
Organization subpart 1 Yes
Enumeration date Apr 26th, 2006
Last updated Oct 9th, 2007 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528025459 NPPES
New York MEDICAID 01752496

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