Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

North Shore Medical Group of Mt Sinai School of Medicine

Organization Internal Medicine Physician · NPI 1003121013

North Shore Medical Group of Mt Sinai School of Medicine is an Internal Medicine Physician in Lake Ronkonkoma, New York. Registered with an NPI since 2010.

In the registry since
2010
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Practice location Address checks out

201 Portion Rd Ste C
Lake Ronkonkoma, NY 11779-4172
Phone: (631) 585-5959
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X

Record details

NPI number1003121013
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Janet Street — Administrator · (631) 351-3703
Other names North Shore Medical Group
NPI enumeratedAugust 13, 2010
Last updated in NPPESAugust 13, 2010
Mailing address201 Portion Rd, Suite C, Lake Ronkonkoma, NY 11779-4172

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