Provider Demographics
NPI:1255384046
Name:SOUND SHORE MEDICAL CENTER
Entity type:Organization
Organization Name:SOUND SHORE MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR VP CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:DALY
Authorized Official - Suffix:
Authorized Official - Credentials:SRVP CFO
Authorized Official - Phone:914-637-1505
Mailing Address - Street 1:16 GUION PLACE
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10802
Mailing Address - Country:US
Mailing Address - Phone:914-664-8000
Mailing Address - Fax:914-664-1877
Practice Address - Street 1:16 GUION PLACE
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10802
Practice Address - Country:US
Practice Address - Phone:914-664-8000
Practice Address - Fax:914-664-1877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY274126Medicaid
NY274126Medicaid