Provider Demographics
NPI:1033281126
Name:NORTH SHORE MEDICAL LABS INC.
Entity Type:Organization
Organization Name:NORTH SHORE MEDICAL LABS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ABID
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEIKH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-739-5227
Mailing Address - Street 1:463 WILLIS AVE
Mailing Address - Street 2:
Mailing Address - City:WILLISTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11596-1724
Mailing Address - Country:US
Mailing Address - Phone:516-739-5227
Mailing Address - Fax:516-739-5244
Practice Address - Street 1:463 WILLIS AVE
Practice Address - Street 2:
Practice Address - City:WILLISTON PARK
Practice Address - State:NY
Practice Address - Zip Code:11596-1724
Practice Address - Country:US
Practice Address - Phone:516-739-5227
Practice Address - Fax:516-739-5244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4349291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYL87071Medicare ID - Type Unspecified