MEDICARE: NORTH SHORE UNIVERSITY 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	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1932472107
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH SHORE UNIVERSITY HOSPITAL

Provider Business Mailing Address
First Line	:	972 BRUSH HOLLOW RD
Second Line	:	FINANCE 5TH FLOOR
City	:	WESTBURY
State	:	NY
Zip	:	11590-1740
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3333 NEW HYDE PARK RD STE 317
Second Line	:
City	:	NEW HYDE PARK
State	:	NY
Zip	:	11042-1205
Country	:	US
Telephone Number	:	516-472-3904
Fax Number	:

Authorized Official
Title or Position	:	SENIOR VICE PRESIDENT & CFO
Name	:	MRS. MICHELE L. CUSACK
Credential	:
Telephone Number	:	516-321-6058

Provider Enumeration Date	:	02/17/2012
Last Update Date	:	12/03/2018

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