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NPI Code Detail

MEDICARE: PENINSULA HOSPITAL CENTER

MEDICARE: PENINSULA HOSPITAL CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1282N00000XGeneral Acute Care Hospital7003006HNY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
100097OTHERNYEMPIRE BLUE CROSS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1184629644
Entity Type Code : Organization
Provider Name (Legal Business Name) : PENINSULA HOSPITAL CENTER
Provider Business Mailing Address
First Line : 5115 BEACH CHANNEL DR
Second Line :
City : FAR ROCKAWAY
State : NY
Zip : 11691-1042
Country : US
Telephone Number : 718-734-2568
Fax Number : 718-734-2545
Provider Business Practice Location Address
First Line : 5115 BEACH CHANNEL DR
Second Line :
City : FAR ROCKAWAY
State : NY
Zip : 11691-1042
Country : US
Telephone Number : 718-734-2568
Fax Number : 718-734-2545
Authorized Official
Title or Position : CEO
Name : ROBERT LEVINE
Credential :
Telephone Number : 718-734-2500
Provider Enumeration Date : 06/20/2005
Last Update Date : 08/22/2020

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Directions to “PENINSULA HOSPITAL CENTER ” Practice Location

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