MEDICARE: NYU LANGONE HOSPITALS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QE0700X	End-Stage Renal Disease (ESRD) Treatment Clinic/Center

General Provider Information

NPI Number	:	1487743480
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NYU LANGONE HOSPITALS

Provider Business Mailing Address
First Line	:	101 HOSPITAL ROAD
Second Line	:
City	:	PATCHOGUE
State	:	NY
Zip	:	11772-4870
Country	:	US
Telephone Number	:	631-654-7100
Fax Number	:	631-654-7664

Provider Business Practice Location Address
First Line	:	109 WEST MAIN STREET
Second Line	:
City	:	PATCHOGUE
State	:	NY
Zip	:	11772-3003
Country	:	US
Telephone Number	:	631-687-2828
Fax Number	:	631-687-2879

Authorized Official
Title or Position	:	SR. VP-CHIEF OF HOSPITAL OPERATIONS
Name	:	DR. MARC ADLER
Credential	:
Telephone Number	:	631-654-7177

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	03/30/2026

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