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Organization
QLIMG LAKE SUCCESS/NEW HYDE PARK MED. OFFICE
Active
Organization
QLIMG LAKE SUCCESS/NEW HYDE PARK MED. OFFICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARLENA SIMPSON CPMSM (DIRECTOR OF CREDENTIALING)
(516) 542-6880
Entity
Organization
Contact information
Practice address
1000 ZECKENDORF BLVD, GARDEN CITY, NY 11530-2133
(516) 355-5800
(516) 355-5877
Mailing address
1991 MARCUS AVE, 2ND FLOOR, NEW HYDE PARK, NY 11042-2057
(516) 354-1600
(516) 941-4672
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
2080P0201X
Pediatric Allergy/Immunology Physician
—
—
2080P0205X
Pediatric Endocrinology Physician
—
—
Other
Enumeration date
10/13/2006
Last updated
10/22/2010
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