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General NPI Number Information
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NPI Number | 1316112097
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Entity Type | Organization
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Legal Business Name | CORNERSTONE OF MEDICAL ARTS CENTER HOSPITAL
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Dates
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Enumeration Date | 04/24/2008
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Last Update Date | 05/08/2008
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Provider Practice Location Address
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Address Line | 15905 UNION TPKE
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City | FLUSHING
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State | NY
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Zip | 11366
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Country | US
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Telephone | 718-906-6700
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Fax |
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Provider Business Mailing Address
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Address Line | 15905 UNION TPKE
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City | FLUSHING
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State | NY
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Zip | 11366
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Country | US
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Telephone | 718-906-6700
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. SAMI KADDOURI
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Credential | MD
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Telephone | 718-906-6700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | F303637
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License Number State | NY
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