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General NPI Number Information
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NPI Number | 1356635494
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Entity Type | Organization
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Legal Business Name | NORTH SHORE UNIVERSITY HOSPITAL
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Dates
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Enumeration Date | 06/07/2011
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Last Update Date | 06/07/2011
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Provider Practice Location Address
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Address Line | 211-21 46 AVE
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City | BAYSIDE
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State | NY
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Zip | 11361
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Country | US
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Telephone | 347-804-6889
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Fax |
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Provider Business Mailing Address
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Address Line | 211-21 46 AVE
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City | BAYSIDE
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State | NY
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Zip | 11361
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. ANNIE WANG
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Credential | M.D.
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Telephone | 347-804-6889
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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 | 258247-1
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License Number State | NY
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