Provider Demographics
NPI:1861743536
Name:SOUTH SHORE SURGICAL SPECIALISTS LLC
Entity type:Organization
Organization Name:SOUTH SHORE SURGICAL SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:IOVINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-335-4815
Mailing Address - Street 1:780 MAIN ST
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:S WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-1622
Mailing Address - Country:US
Mailing Address - Phone:781-335-4815
Mailing Address - Fax:781-340-5356
Practice Address - Street 1:780 MAIN ST
Practice Address - Street 2:SUITE 2A
Practice Address - City:S WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-1622
Practice Address - Country:US
Practice Address - Phone:781-335-4815
Practice Address - Fax:781-340-5356
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTH SHORE SURGICAL SPECIALISTS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-09-21
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty