SOUTH SHORE FAMILY MEDICAL ASSOCIATES, P.C. (NPI# 1720122716) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720122716 |
| Entity Type | Organization |
| Organization Name | SOUTH SHORE FAMILY MEDICAL ASSOCIATES, P.C. |
| Practice Address |
271 Doughty Blvd Inwood NY 11096-2135 |
| Practice Telephone | 5163716884 |
| Practice Fax Number | 5163716083 |
| Mailing Telephone | 5163716884 |
| Mailing Fax Number | 5163716083 |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. ALLAN SCOTT DETWEILER (PRESIDENT) |
| Authorized Official Telephone | 5163716884 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 205232 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01824973 | 05 |
| Street Address |
271 DOUGHTY BLVD |
| City | INWOOD |
| State | NY |
| Zip Code | 11096-2135 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992706402 | Allan Scott Detweiler | Family Medicine | 271 Doughty Blvd, Inwood, NY 11096-2135 | 2005-08-09 |
| 1053961896 | General Surgery Consultant PC | Surgery | 271 Doughty Blvd, Inwood, NY 11096-2135 | 2019-09-13 |
| 1740768191 | Brittany Lynn Amato | Physician Assistant | 271 Doughty Blvd, Inwood, NY 11096-2135 | 2018-07-29 |
| 1811499239 | Natalie Helen Cain | Physician Assistant | 271 Doughty Blvd, Inwood, NY 11096-2135 | 2018-03-01 |
| 1891214987 | Francesca Ghassan | Physician Assistant | 271 Doughty Blvd, Inwood, NY 11096-2135 | 2017-09-11 |
| 1356881502 | Alexandra Scialdone | Physician Assistant | 271 Doughty Blvd, Inwood, NY 11096-2135 | 2017-03-06 |
| 1396285177 | Beatriz Woodworth | Physician Assistant | 271 Doughty Blvd, Inwood, NY 11096-2135 | 2017-02-28 |
| 1326402009 | Alan T. Glass, Md, Dermatology LLC | Dermatology | 271 Doughty Blvd, Inwood, NY 11096-2135 | 2016-04-08 |
| 1851751713 | Jennifer Raye | Physician Assistant | 271 Doughty Blvd, Inwood, NY 11096-2135 | 2016-03-03 |
| 1609179662 | Stefan Barker | Physician Assistant | 271 Doughty Blvd, Inwood, NY 11096-2135 | 2010-12-14 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568973592 | Andreadenise Jacqueline Gray | Behavior Technician | 600 Bayview Ave Ste 309, Inwood, NY 11096 | 2017-10-17 |
| 1407118557 | Julie Ann Ackerman | Specialist | 188 Donahue Ave, Inwood, NY 11096 | 2012-06-14 |
| 1164706362 | Ilene Rona Isler | Speech-Language Pathologist | 1 Donahue Avenue, Number Two School, Inwood, NY 11096 | 2011-10-06 |
| 1790064582 | Sharon Rae Solomon-fried Cander | Social Worker | #1 Donahue Ave, Public School Number Two, Inwood, NY 11096 | 2011-08-10 |
| 1548567217 | Stephanie Hazel Campbell | Speech-Language Pathologist | Donahue Avenue, Number Two School, Inwood, NY 11096 | 2011-02-16 |
| 1659678472 | Anthony Thomas Procaccino Jr. | Psychologist | 1 Donahue Ave. Number Two Elementary School, Lawrence Public Schools, Inwood, NY 11096 | 2011-02-14 |
| 1760792089 | Janice Patricia Mcphaul-guerrier | Licensed Practical Nurse | 87 Wanser Avenue, Lawrence Public School # 4, Inwood, NY 11096 | 2010-10-20 |
| 1376857979 | Hilary E. Shein Rothman | Physical Therapist | 90 Henry Street, Inwood, NY 11096 | 2010-08-06 |
| 1144335712 | Carlos A Menera | Obstetrics & Gynecology | 270 Doughty Blvd, Inwood, NY 11096 | 2006-08-21 |
| 1881619708 | Inwood Community Health Center | Clinic/Center | 270 Lawrence Ave., Inwood, NY 11096 | 2006-07-13 |
| Find all providers in zip 11096 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437581733 | University Healthcare Physicians, Inc. | Family Medicine | 5047 Gerrardstown Rd, Ste A, Inwood, WV 25428-3951 | 2013-08-08 |
| 1881893550 | Shenandoah Valley Family Health Center | Family Medicine | 102 Hovater Drive, Inwood, WV 25428 | 2007-07-13 |
| 1245437979 | Amanda Combs Prince | Family Medicine | 5047 Gerrardstown Rd Ste 2b, Inwood, WV 25428-3951 | 2007-06-27 |
| 1992706402 | Allan Scott Detweiler | Family Medicine | 271 Doughty Blvd, Inwood, NY 11096-2135 | 2005-08-09 |
| 1851398820 | Chandra M Gupta | Family Medicine | 101 Doughty Blvd, Inwood, NY 11096-2003 | 2005-07-05 |
| 1033681150 | East Mountain Health Physicians, Inc. | Family Medicine | 4803 Gerrardstown Rd, Inwood, WV 25428-3450 | 2018-12-31 |
| 1720424625 | Inwood Family Practice and Osteopathic Medicine P.C. | Family Medicine | 101 Doughty Blvd, Inwood, NY 11096-2003 | 2013-05-17 |
| 1033400379 | Patrick Francis O'neil | Family Medicine | 4803 Gerrardstown Rd, Inwood, WV 25428-3450 | 2011-04-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881295558 | Mamoon Malik | Family Medicine | 90 Menands Rd, Albany, NY 12204-1400 | 2020-11-08 |
| 1336749571 | Chowdhury Medical PC | Family Medicine | 155 Alkier St, Brentwood, NY 11717-5129 | 2020-10-27 |
| 1356940084 | Rebecca Jean Smouse | Family Medicine | 1107 Prendergast Ave, Jamestown, NY 14701-3315 | 2020-10-23 |
| 1336748136 | Rapha House Calls | Family Medicine | 2 Fernglade Ct, Chester, NY 10918-2637 | 2020-10-22 |
| 1174122980 | Richmond Health Partners Ipa LLC | Family Medicine | 1161 Victory Blvd, Staten Island, NY 10301-3621 | 2020-10-22 |
| 1730787128 | Michael C Secallus | Family Medicine | 66 Kirkwood Gdns, Kirkwood, NY 13795-1623 | 2020-10-16 |
| 1861099053 | Julia Gross Family Health Nurse Practitioner, Pllc | Family Medicine | 950 Route 146 Ste 100, Clifton Park, NY 12065-3667 | 2020-10-01 |
| 1013523190 | Steinway Hope Medical LLC | Family Medicine | 8829 54th Ave Fl 2, Elmhurst, NY 11373-4543 | 2020-09-23 |
| 1538774500 | Jenny Brandt | Family Medicine | 3048 Sunset Ln # 2, Schenectady, NY 12303-5528 | 2020-09-15 |
| 1992319016 | Sarah Glaser | Family Medicine | 30 W 24th St, New York, NY 10010-3207 | 2020-09-04 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.