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General NPI Number Information
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NPI Number | 1841320967
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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 | 03/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7559 263 STREET LOWENSTEIN PAVILION 140
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City | GLEN OAKS
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State | NY
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Zip | 11004
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Country | US
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Telephone | 718-470-8341
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Fax | 718-962-2742
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Provider Business Mailing Address
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Address Line | 36 GRANT WAY
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City | PRINCETON
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State | NJ
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Zip | 08540-1693
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Country | US
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Telephone | 609-279-0351
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Fax | 718-962-2742
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. CHANTAL WEINHOLD
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Credential | M.S.
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Telephone | 718-470-8055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number | 002774-1
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License Number State | NY
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