Healthcare Provider Details

I. General information

NPI: 1427428150
Provider Name (Legal Business Name): NORTH SHORE LONG ISLAND JEWISH HEALTHCARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2015
Last Update Date: 11/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

972 BRUSH HOLLOW RD FINANCE - 5TH FLOOR
WESTBURY NY
11590-1740
US

IV. Provider business mailing address

888 OLD COUNTRY RD
PLAINVIEW NY
11803-4914
US

V. Phone/Fax

Practice location:
  • Phone: 516-876-6065
  • Fax: 516-876-5572
Mailing address:
  • Phone: 516-796-1313
  • Fax: 516-719-3055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT S SHAPIRO
Title or Position: EXECUTIVE VP & CFO
Credential:
Phone: 516-465-8162