Provider Demographics
NPI:1497714877
Name:NORTH SHORE DIABETES AND ENDOCRINE ASSOC
Entity Type:Organization
Organization Name:NORTH SHORE DIABETES AND ENDOCRINE ASSOC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:CESARE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-327-0850
Mailing Address - Street 1:3003 NEW HYDE PARK RD
Mailing Address - Street 2:201
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1214
Mailing Address - Country:US
Mailing Address - Phone:516-327-0850
Mailing Address - Fax:516-327-0920
Practice Address - Street 1:3003 NEW HYDE PARK RD
Practice Address - Street 2:201
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1214
Practice Address - Country:US
Practice Address - Phone:516-327-0850
Practice Address - Fax:516-327-0920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
Not Answered207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0028581OtherGHI
2336956OtherAETNA
2336956OtherAETNA