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SOUTH SHORE PSYCHIATRIC NURSE PRACTITIONER GROUP
NPI 1558979377
Nurse Practitioner - Psychiatric/Mental Health in Bay Shore, NY

Active since July 17, 2020
245 W MAIN ST, BAY SHORE, NY 11706(631) 771-7555 Get Directions Write a Review

NPPES record last updated: July 21, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 21, 2020, Jul 17, 2020 (2 updates tracked since 2020).

About South Shore Psychiatric Nurse Practitioner Group NPPES

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

SOUTH SHORE PSYCHIATRIC NURSE PRACTITIONER GROUP (NPI 1558979377) is a healthcare organization registered as a psychiatric/mental health in Bay Shore, New York and active in the NPI registry since July 2020. The organization lists Tennille Braithwaite, Office Mgr, as its authorized official.

NPPES Registry Identity

NPI1558979377
Entity TypeOrganization
Primary Taxonomy363LP0808X
Legal Business NameSOUTH SHORE PSYCHIATRIC NURSE PRACTITIONER GROUP
Location Address245 W MAIN STBay Shore, NY 11706-8323
Mailing Address154 Chichester AveCenter Moriches, NY 11934-2004 · (631) 400-9251 · Fax (516) 447-3403
Phone(631) 771-7555
Organization SubpartNo
Authorized OfficialTennille BraithwaiteOffice Mgr · (631) 400-9251
Enumeration DateJuly 17, 2020
Last NPPES UpdateJuly 21, 20202 updates tracked since enumeration
NPPES CertifiedJuly 21, 2020
✔ NPI 1558979377 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
245 W MAIN ST, Bay Shore, NY 11706
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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

Other Providers at the Same Location NPPES 4

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

MS. JENNIFER ROSE ROGAN NP
Nurse Practitioner (Psychiatric/Mental Health)
245 W MAIN ST
BAY SHORE, NY 11706
Suffolk County (631) 626-4615
DR. RAYMOND ROCCO MAGLIULO DO
Family Medicine (Adult Medicine)
245 W MAIN ST
BAY SHORE, NY 11706
Suffolk County (631) 969-0000
DR. DIANE HILDE MAGLIULO DO
Family Medicine (Adult Medicine)
245 W MAIN ST
BAY SHORE, NY 11706
Suffolk County (631) 969-0000
DIANE AND RAYMOND MAGLIULO, DO PC
Clinic/Center (Primary Care)
245 W MAIN ST
BAY SHORE, NY 11706
Suffolk County (631) 969-0000

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 Psychiatric Nurse Practitioner Group's NPI number?

The NPI number for South Shore Psychiatric Nurse Practitioner Group is 1558979377. It was assigned to this organization in the NPPES registry on July 17, 2020.

Where is South Shore Psychiatric Nurse Practitioner Group located?

South Shore Psychiatric Nurse Practitioner Group is located at 245 W Main St, Bay Shore, NY 11706. The listed phone number is (631) 771-7555.

What is South Shore Psychiatric Nurse Practitioner Group's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

When was this NPI record last updated?

The NPPES record for South Shore Psychiatric Nurse Practitioner Group was last updated on July 21, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.