Healthcare Provider Details

I. General information

NPI: 1992856769
Provider Name (Legal Business Name): JAMAICA HOSPITAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171-23 111TH AVE.
ST. ALBANS NY
11433
US

IV. Provider business mailing address

4153 57TH ST
WOODSIDE NY
11377-4745
US

V. Phone/Fax

Practice location:
  • Phone: 718-206-9888
  • Fax:
Mailing address:
  • Phone: 917-476-7781
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number049290
License Number StateNY

VIII. Authorized Official

Name: DR. DAVID EPSTEIN
Title or Position: DDS
Credential:
Phone: 718-739-9662