| Organization Name: | THE SOUTH SHORE WELLNESS CENTER CORP |
| NPI Number: | 1588850358 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LISA M PALERMO (PRESIDENT) |
| Mailing Address: | 2915 Sunrise Hwy Islip Terrace |
| State: | NY US |
| Postal Code: | 117522716 |
| Phone Number: | 6315816900 |
| Fax Number: | 6315816910 |
| NPI Enumeration Date: | 09/14/2007 |
| NPI Last Update Date: | 09/14/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |