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Organization
NORTH SHORE-LIJ MEDICAL GROUP P.C.
Active
Organization
NORTH SHORE-LIJ MEDICAL GROUP P.C.
Active
Other names
North Shore University Hospital Independence at Home Demonstration
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELE CUSAK (CFO)
(516) 321-6025
Entity
Organization
Contact information
Practice address
300 COMMUNITY DR, MANHASSET, NY 11030-3816
(516) 876-5555
Mailing address
PO BOX 11173, NEW YORK, NY 10087-1173
(516) 876-5555
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
—
—
Other
Enumeration date
01/12/2016
Last updated
07/25/2022
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