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General NPI Number Information
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NPI Number | 1871024455
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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 | 03/24/2017
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Last Update Date | 12/29/2022
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Provider Practice Location Address
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Address Line | 7559 263RD ST VIVO HEALTH PHARMACY AT ZUCKER HILLSIDE HOSPITAL
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City | GLEN OAKS
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State | NY
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Zip | 11004-1150
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Country | US
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Telephone | 718-470-5611
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Fax | 718-470-5612
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Provider Business Mailing Address
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Address Line | 1983 MARCUS AVE STE 118
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City | NEW HYDE PARK
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State | NY
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Zip | 11042-1016
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Country | US
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Telephone | 718-470-5611
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Fax | 718-470-5612
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Authorized Official
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Title or Position | SVP, CHIEF EXPENSE OFFICER
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Name | MRS. DONNA DRUMMOND
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Credential |
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Telephone | 718-470-5611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 035154
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License Number State | NY
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