# LONG ISLAND COLLEGE HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MEDICINE SPECIALTY GROUP AT LICH
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003863820
- **Authorized official:** VLADIMIR PRIVMAN MD (MANAGING EMPLOYEE)
- **Authorized official phone:** (718) 780-2155

## Contact information

- **Practice address:** 97 AMITY ST, BROOKLYN, NY 11201-6004
- **Practice address phone:** (718) 780-2155
- **Mailing address:** 160 WATER ST, 20FL, NEW YORK, NY 10038-4922
- **Mailing address phone:** (212) 256-3682
- **Mailing address fax:** (212) 256-3538

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | NULL | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | — |
| 207RG0100X | Gastroenterology Physician | — | NULL | Yes |
| 207RG0100X | Gastroenterology Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/27/2006
- **Last updated:** 11/03/2009