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General NPI Number Information
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NPI Number | 1174530349
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Entity Type | Organization
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Legal Business Name | LONG ISLAND JEWISH MEDICAL CENTER
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 26901 76TH AVE
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-1433
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Country | US
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Telephone | 718-470-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 972 BRUSH HOLLOW RD FL 5
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City | WESTBURY
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State | NY
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Zip | 11590-1740
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Country | US
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Telephone | 516-876-6000
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Fax | 516-876-6600
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Authorized Official
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Title or Position | SENIOR VICE PRESIDENT & CFO
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Name | MRS. MICHELE LEE CUSACK
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Credential |
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Telephone | 516-321-6058
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC2000X
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Taxonomy Name | Children's Hospital
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License Number | 7003004H
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License Number State | NY
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