Healthcare Provider Details

I. General information

NPI: 1497089841
Provider Name (Legal Business Name): NORTH SHORE HEALTH SYSTEM PLAINVIEW
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2009
Last Update Date: 10/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

888 OLD COUNTRY RD
PLAINVIEW NY
11803-4914
US

IV. Provider business mailing address

71 N BROADWAY
HICKSVILLE NY
11801-2942
US

V. Phone/Fax

Practice location:
  • Phone: 516-719-2435
  • Fax:
Mailing address:
  • Phone: 516-938-0020
  • Fax: 516-470-1475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License NumberF304305
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberF304305
License Number StateNY

VIII. Authorized Official

Name: MR. ALAN MENSCH
Title or Position: CHIEF MEDICAL DIRECTOR INTERNAL MED
Credential: MD
Phone: 516-719-2353