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SOUTH SHORE WOMENS CARE PLLC
NPI 1174190326
Obstetrics & Gynecology in West Islip, NY

Active since June 07, 2021CLIA 33D2344128 · Waiver
750 MONTAUK HWY, WEST ISLIP, NY 11795(347) 523-0054 Get Directions Write a Review

NPPES record last updated: June 7, 2021. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About South Shore Womens Care Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTH SHORE WOMENS CARE PLLC (NPI 1174190326) is a healthcare organization registered as an obstetrics & gynecology in West Islip, New York and active in the NPI registry since June 2021. The organization holds a CLIA Waiver certificate valid through May 17, 2028, maintains a secondary practice location in Lindenhurst, and lists Larissa Fomitcheva, President, as its authorized official.

NPPES Registry Identity

NPI1174190326
Entity TypeOrganization
Primary Taxonomy207V00000X
Legal Business NameSOUTH SHORE WOMENS CARE PLLC
Location Address750 MONTAUK HWYWest Islip, NY 11795-4411
Mailing Address21 Cobblers LnDix Hills, NY 11746-5020
Phone(347) 523-0054
Organization SubpartNo
Authorized OfficialLarissa FomitchevaPresident · (347) 523-0054
Enumeration DateJune 7, 2021
NPPES CertifiedJune 7, 2021
✔ NPI 1174190326 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
750 MONTAUK HWY, West Islip, NY 11795
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Secondary Practice Location 1

Location 157 W Sunrise HwyLindenhurst, NY 11757-2421 · Phone (347) 523-0054

Other Identifiers 1

Medicaid02834742NY

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D2344128

Southshore Women's Care PLLC · Lindenhurst, NY
Active · expires May 17, 2028
CLIA Number33D2344128
Laboratory TypePhysician Office
Certificate Effective DateMay 18, 2026
Certificate Expiration DateMay 17, 2028
Laboratory DirectorLarissa Fomitcheva
Laboratory Phone(631) 466-5242
Laboratory LocationSouthshore Women's Care PLLC57 W Sunrise Highway, Lindenhurst, NY 11757
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ATHANASIOS ANTONIADIS OB GYN PC
Obstetrics & Gynecology
750 MONTAUK HWY
WEST ISLIP, NY 11795
Suffolk County (631) 376-1010
ATHANASIOS ANTONIADIS M.D.
Obstetrics & Gynecology
750 MONTAUK HWY
WEST ISLIP, NY 11795
Suffolk County (631) 376-1010
JOANNE LAMONICA MD PC
Specialist
750 MONTAUK HWY
WEST ISLIP, NY 11795
Suffolk County (631) 620-3222

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is South Shore Womens Care PLLC's NPI number?

The NPI number for South Shore Womens Care PLLC is 1174190326. It was assigned to this organization in the NPPES registry on June 7, 2021.

Where is South Shore Womens Care PLLC located?

South Shore Womens Care PLLC is located at 750 Montauk Hwy, West Islip, NY 11795. The listed phone number is (347) 523-0054.

What is South Shore Womens Care PLLC's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Does South Shore Womens Care PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2344128) is associated with this NPI, valid through May 17, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for South Shore Womens Care PLLC was last updated on June 7, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.