Provider Demographics
NPI:1871896548
Name:SOUTH SHORE SURGICAL PAIN MANAGEMENT, PC
Entity type:Organization
Organization Name:SOUTH SHORE SURGICAL PAIN MANAGEMENT, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:STARKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-766-8900
Mailing Address - Street 1:2965 LONG BEACH RD
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-3204
Mailing Address - Country:US
Mailing Address - Phone:516-766-8900
Mailing Address - Fax:516-766-3357
Practice Address - Street 1:2965 LONG BEACH RD
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-3204
Practice Address - Country:US
Practice Address - Phone:516-766-8900
Practice Address - Fax:516-766-3357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-17
Last Update Date:2010-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty