Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

South Shore Faculty Medical Affiliates, University Faculty Practice Co

Organization Physician Assistant · NPI 1720824840

South Shore Faculty Medical Affiliates, University Faculty Practice Co provides Physician Assistant services in Bay Shore, New York. Registered with an NPI since 2024.

In the registry since
2024

Practice location Address checks out

301 E Main St
Bay Shore, NY 11706-8408
Phone: (631) 968-3000
Fax: (631) 968-3315
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1720824840
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Victoria Gangale — Physician Assistant · (631) 968-3000
NPI enumeratedJuly 8, 2024
Last updated in NPPESJuly 8, 2024
Certification dateJuly 8, 2024
Mailing address301 E Main St, Bay Shore, NY 11706-8408

Other providers in Bay Shore