OrganizationGary Shore Md PcInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address31 Merrick Ave, Suite 230, Merrick, NY 11566-3477(516) 377-2820PECOS EnrollmentBased on the most recent information from CMS, provider Gary Shore Md Pc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1295962751Provider TypeOrganizationFull NameGary Shore Md PcSubpartNoEnumeration Date6/11/2009Last Updated4/20/2010Contact InformationPractice LocationPractice Address31 Merrick Ave, Suite 230, Merrick, NY 11566-3477Phone(516) 377-2820Fax(516) 378-2968Mailing LocationMailing Address87 E Lexington Ave, Oceanside, NY 11572-5420Phone(516) 377-2820Fax(516) 378-2968Authorized OfficialNameShore, Gary J (President)Phone(516) 377-2820Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense179490New YorkProvider IdentifiersIDDescriptionIssuerIDDP304DescriptionOtherIssuerOXFORDID179491N01DescriptionOtherIssuerHIPNew York