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Organization
NORTH SHORE-LIJ MEDICAL GROUP AT HUNTINGTON PC
Active
Organization
NORTH SHORE-LIJ MEDICAL GROUP AT HUNTINGTON PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELE L CUSACK (SENIOR VICE PRESIDENT & CFO)
(516) 321-6058
Entity
Organization
Contact information
Practice address
2001 MARCUS AVE STE S50, NEW HYDE PARK, NY 11042-1039
(516) 328-9800
(516) 328-9801
Mailing address
2001 MARCUS AVE STE S50, NEW HYDE PARK, NY 11042-1039
(516) 328-9800
(516) 328-9801
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
—
NULL
208600000X
Surgery Physician
—
—
2086S0129X
Vascular Surgery Physician
Primary
—
NULL
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Enumeration date
06/08/2020
Last updated
07/08/2022
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