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General NPI Number Information
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NPI Number | 1093657751
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Entity Type | Organization
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Legal Business Name | LONG ISLAND JEWISH FACULTY MEDICAL AFFILIATES, UNIVERSITY FACULTY PRAC
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Dates
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Enumeration Date | 04/09/2026
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Last Update Date | 04/09/2026
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Provider Practice Location Address
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Address Line | 100 PORT WASHINGTON BLVD
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City | ROSLYN
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State | NY
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Zip | 11576-1347
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Country | US
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Telephone | 516-608-6820
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Fax | 516-562-3675
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Provider Business Mailing Address
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Address Line | 850 HICKSVILLE RD STE 104
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City | SEAFORD
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State | NY
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Zip | 11783-1300
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Country | US
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Telephone | 516-541-2233
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Fax | 516-541-2456
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Authorized Official
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Title or Position | DIRECTOR
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Name | SHARLENE BRONSTORPH
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Credential |
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Telephone | 516-850-3999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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