Healthcare Provider Details

I. General information

NPI: 1679934509
Provider Name (Legal Business Name): MCGAW MEDICAL CENTRE OF NORTHWESTERN UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2016
Last Update Date: 03/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

TEMPLE STREET CHILDREN'S UNIVERSITY HOSPITAL TEMPLE STREET
DUBLIN DUBLIN 1
D01F772
IE

IV. Provider business mailing address

DEMESNE LANE
LONGFORD LONGFORD
N39 AOC8
IE

V. Phone/Fax

Practice location:
  • Phone: 35318784200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number
License Number State

VIII. Authorized Official

Name: JOSHUA GOLDSTEIN
Title or Position: ASSOCIATE DEAN FOR GME
Credential: M.D.
Phone: 312-503-7975