Healthcare Provider Details

I. General information

NPI: 1285842062
Provider Name (Legal Business Name): ZUCKER HILLSIDE HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 11/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7959 263RD ST
GLEN OAKS NY
11004-1306
US

IV. Provider business mailing address

7516 182ND ST
FLUSHING NY
11366-1614
US

V. Phone/Fax

Practice location:
  • Phone: 718-780-4265
  • Fax:
Mailing address:
  • Phone: 917-834-5227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State

VIII. Authorized Official

Name: DR. HOONHEE SHIN
Title or Position: HOUSE STAFF
Credential: M.D.
Phone: 718-470-8005