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General NPI Number Information
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NPI Number | 1245432483
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Entity Type | Organization
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Legal Business Name | JAMAICA HOSPITAL MEDICAL CENTER
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Dates
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Enumeration Date | 06/01/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8900 VAN WYCK EXPY
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City | JAMAICA
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State | NY
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Zip | 11418-2897
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Country | US
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Telephone | 718-206-6715
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Fax | 718-206-6797
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Provider Business Mailing Address
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Address Line | 3304 PARK AVE
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City | OCEANSIDE
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State | NY
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Zip | 11572-4352
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Country | US
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Telephone | 516-270-2126
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Fax | 516-255-2006
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Authorized Official
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Title or Position | HOUSE OFFICER
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Name | DR. GRIGORY LEONTYEV
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Credential | M.D.
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Telephone | 718-206-6715
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 228112
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License Number State | NY
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