MEDICARE: LONG ISLAND COLLEGE HOSPITAL

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
1	261QD0000X	Dental Clinic/Center	052194	NY

General Provider Information

NPI Number	:	1881809390
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LONG ISLAND COLLEGE HOSPITAL

Provider Business Mailing Address
First Line	:	8701 SHORE RD APT 223
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-4246
Country	:	US
Telephone Number	:	917-699-5043
Fax Number	:

Provider Business Practice Location Address
First Line	:	8701 SHORE RD APT 223
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-4246
Country	:	US
Telephone Number	:	917-699-5043
Fax Number	:

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. FILOMENA M PAPAPIETRO
Credential	:	D.D.S
Telephone Number	:	917-699-5043

Provider Enumeration Date	:	05/10/2007
Last Update Date	:	08/22/2020

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