ProviderBusinessMailingAddressFaxNumber = '6316474568'
NPI
LastName
FirstName
MidName
Organization
Mailing Address
City
State
Zip
1134848070
SOUTH SHORE BAY SHORE MEDICAL PC
24 BRENTWOOD RD # D
BAY SHORE
NY
117068011
1649767559
GEORGE
ELIZABETH
V
616 BROADWAY
MASSAPEQUA
NY
117585024
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