# NORTH SHORE -LIJ OB-GYN AT NEW HYDE PARK, P.C.

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

## Provider details

- **NPI number:** 1861889461
- **Authorized official:** MRS. MICHELE CUSAK (CFO)
- **Authorized official phone:** (516) 465-8162

## Contact information

- **Practice address:** 3003 NEW HYDE PARK RD, SUITE 407, NEW HYDE PARK, NY 11042-1206
- **Practice address phone:** (516) 823-8110
- **Mailing address:** 3003 NEW HYDE PARK RD, NEW HYDE PARK, NY 11042-1206

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/21/2015
- **Last updated:** 07/26/2022