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

South Shore Faculty Medical Affiliates, University Faculty Practice Co

Organization Physician Assistant · NPI 1720824840

South Shore Faculty Medical Affiliates, University Faculty Practice Co is a Physician Assistant in Bay Shore, New York. Registered with an NPI since 2024.

In the registry since
2024

Practice location Address checks out

301 E Main St
Bay Shore, NY 11706-8408
Phone: (631) 968-3000
Fax: (631) 968-3315
Show map & directions

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

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1720824840
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Victoria Gangale — Physician Assistant · (631) 968-3000
NPI enumeratedJuly 8, 2024
Last updated in NPPESJuly 8, 2024
Certification dateJuly 8, 2024
Mailing address301 E Main St, Bay Shore, NY 11706-8408

Other providers in Bay Shore