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

Southside Hospital Emergency Department

Organization Emergency Medicine Physician · NPI 1528025459

Southside Hospital Emergency Department is an Emergency Medicine Physician in Bay Shore, New York. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
4

Practice location Address checks out

301 E Main St
Bay Shore, NY 11706-8408
Phone: (631) 675-4149
Show map & directions

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

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X
Internal Medicine Physician Taxonomy 207R00000X
Pediatrics Physician Taxonomy 208000000X
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1528025459
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationSouthside Hospital
Authorized official Winifred Mack — Cfo · (631) 968-9000
NPI enumeratedApril 26, 2006
Last updated in NPPESOctober 9, 2007
Mailing address301 E Main St, Bay Shore, NY 11706-8408

Other providers in Bay Shore