Provider Demographics
NPI:1225399884
Name:NORTH SHORE PROCEDURES, LLC
Entity Type:Organization
Organization Name:NORTH SHORE PROCEDURES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALI
Authorized Official - Middle Name:S
Authorized Official - Last Name:KARAKURUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-331-0200
Mailing Address - Street 1:70 N COUNTRY RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PORT JEFFERSON
Mailing Address - State:NY
Mailing Address - Zip Code:11777-2161
Mailing Address - Country:US
Mailing Address - Phone:631-331-0200
Mailing Address - Fax:631-331-0202
Practice Address - Street 1:70 N COUNTRY RD
Practice Address - Street 2:SUITE 201
Practice Address - City:PORT JEFFERSON
Practice Address - State:NY
Practice Address - Zip Code:11777-2161
Practice Address - Country:US
Practice Address - Phone:631-331-0200
Practice Address - Fax:631-331-0202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-30
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY185973261QE0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0800XAmbulatory Health Care FacilitiesClinic/CenterEndoscopy