NPI 1093723488

Long Island Jewish Medical Center

Organisation End-Stage Renal Disease (ESRD) Treatment Clinic/Center Queens Village, NY

Practice location

Address: 22022 Hillside Avenue, Queens Village, NY 11427-2020
Phone: (516) 876-6000
Fax: (516) 876-6600
Mailing address: 972 Brush Hollow Rd 5th Flooor Finance, Westbury, NY 11590-1740

Authorised official

Name: Michele Lee Cusack
Title: Senior Vice President & Cfo
Phone: (516) 321-6058

Registered specialties

End-Stage Renal Disease (ESRD) Treatment Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261QE0700X Licence 7003004H (NY)

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Registry record

NPI: 1093723488
Entity type: Organization
NPI issued: 3 Aug 2006
Record last updated: 28 Nov 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.