Provider Demographics
NPI:1407991144
Name:NORTH SHORE HEMATOLOGY ONCOLOGY,PLLC
Entity Type:Organization
Organization Name:NORTH SHORE HEMATOLOGY ONCOLOGY,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:SETH
Authorized Official - Last Name:FORTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-627-1221
Mailing Address - Street 1:1201 NORTHERN BLVD
Mailing Address - Street 2:
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-3001
Mailing Address - Country:US
Mailing Address - Phone:516-627-1221
Mailing Address - Fax:516-365-1301
Practice Address - Street 1:1201 NORTHERN BLVD
Practice Address - Street 2:
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-3001
Practice Address - Country:US
Practice Address - Phone:516-627-1221
Practice Address - Fax:516-365-1301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW32441Medicare PIN
CI6306Medicare PIN
NYG100000102Medicare PIN