Shangold, Lee Merrick

Shangold, Lee Merrick is an individual health care provider with primary practice located at 1500 Route 112 Bldg. 4 - 2Nd Floor, Port Jefferson Station NY 11776-8054. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Otolaryngology, Allopathic & Osteopathic Physicians / Sleep Medicine. Allopathic & Osteopathic Physicians / Sleep Medicine is his primary health care specialty. Shangold, Lee Merrick can be contacted via phone (631) 828-7001.

Contact Information

Primary practice address
1500 Route 112 Bldg. 4 - 2Nd Floor Port Jefferson Station NY 11776-8054
Phone: (631) 828-7001
Fax: (631) 928-0185
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 172268-1 New York
Allopathic & Osteopathic Physicians / Sleep Medicine 207YS0012X 172268 New York

Profile Details

NPI number 1902887730
LBN Legal business name Shangold, Lee Merrick
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 9th, 2005
Last updated Jan 23rd, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902887730 NPPES
New York MEDICAID 1502405
New York Other P01210116

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