Healthcare Provider Details

I. General information

NPI: 1487743480
Provider Name (Legal Business Name): NYU LANGONE HOSPITALS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 WEST MAIN STREET
PATCHOGUE NY
11772-3003
US

IV. Provider business mailing address

101 HOSPITAL ROAD
PATCHOGUE NY
11772-4870
US

V. Phone/Fax

Practice location:
  • Phone: 631-687-2828
  • Fax: 631-687-2879
Mailing address:
  • Phone: 631-654-7100
  • Fax: 631-654-7664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

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