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

North Shore Medical PLLC

Organization Internal Medicine Physician · NPI 1083966170

North Shore Medical PLLC is an Internal Medicine Physician in Rego Park, New York. Licensed in New York. Registered with an NPI since 2012.

Licensed in
NY
In the registry since
2012
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

9308 Queens Blvd # 1B1C
Rego Park, NY 11374-1135
Phone: (718) 806-1434
Fax: (718) 806-1435
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 187770 (NY)

Record details

NPI number1083966170
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Marvin Base — Director · (718) 806-1434
NPI enumeratedOctober 12, 2012
Last updated in NPPESDecember 11, 2024
Certification dateDecember 11, 2024
Mailing address9308 Queens Blvd # 1b1c, Rego Park, NY 11374-1135

Other providers in Rego Park