Healthcare Provider Details

I. General information

NPI: 1437575396
Provider Name (Legal Business Name): WINTHROP UNIVERSITY HOSPITAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2014
Last Update Date: 03/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 OLD COUNTRY RD SUITE 460
MINEOLA NY
11501-4235
US

IV. Provider business mailing address

700 HICKSVILLE RD SUITE 204
BETHPAGE NY
11714-3471
US

V. Phone/Fax

Practice location:
  • Phone: 516-663-2752
  • Fax: 516-663-9373
Mailing address:
  • Phone: 516-576-5810
  • Fax: 576-576-5801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN COLLINS
Title or Position: CEO
Credential:
Phone: 516-663-2311