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Contact Information

LEE M SHANGOLD, MD
1500 ROUTE 112
BLDG. 4 - 2ND FLOOR
PORT JEFFERSON STATION, NY11776-8054
 Phone: 631-828-7001
 Fax: 631-928-0185
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Sleep Medicine

207YS0012X 04 Physician/Otolaryngology
 

Otolaryngology

207Y00000X 04 Physician/Otolaryngology
Indicates primary specialty

NPI Profile & details for LEE M SHANGOLD · (Male)

NPI # 1902887730
Status Active
Credentials MD
Entity Individual
Enumeration date 11/09/2005
Last updated 01/23/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • NY License # 172268
  • NY License # 172268-1
  • NY Medicaid 1502405
  • NY Other P01210116 RAILROAD MEDICARE PIN
Hospital affiliation(s)
  • ST CHARLES HOSPITAL - (Acute Care)
    200 BELLE TERRE ROAD
    PORT JEFFERSON, NY 11777
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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