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Organization

NORTH SHORE HEALTH SYSTEM MEDICAL FACULTY GROUP PRACTICE INC

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
450 LAKEVILLE RD, NEW HYDE PARK, NY 11042-1118
(516) 734-8900
(516) 734-8934
Mailing address
450 LAKEVILLE RD, NEW HYDE PARK, NY 11042-1118
(516) 734-8900
(516) 734-8934

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary

Other

Enumeration date
02/19/2021
Last updated
02/19/2021
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