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Organization
QUEENS HOSPITAL
Active
Organization
QUEENS HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAISE JOSEPH LCSW (SOCIAL WORKER)
(516) 320-9007
Entity
Organization
Contact information
Practice address
8268 164TH ST, JAMAICA, NY 11432-1121
(718) 883-3557
Mailing address
1796 GRANT AVE, EAST MEADOW, NY 11554-1646
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110589550
—
NY
05
—
632984033
—
NY
Enumeration date
03/13/2019
Last updated
03/13/2019
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