# GOOD SAMARITAN HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033401211
- **Authorized official:** MISS ELIZABETH MARION JAQUAY MSOTR/L (OCCUPATIONAL THERAPIST)
- **Authorized official phone:** (631) 376-3076

## Contact information

- **Practice address:** 1000 MONTAUK HIGHWAY, WEST ISLIP, NY 11795
- **Practice address phone:** (631) 376-3069
- **Mailing address:** 1000 MONTAUK HIGHWAY, WEST ISLIP, NY 11795

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0401X | Comprehensive Outpatient Rehabilitation Facility (CORF) | 0160601 | NY | Yes |

## Other

- **Enumeration date:** 05/06/2011
- **Last updated:** 05/06/2011