Organization
LONG ISLAND COLLEGE HOSPITAL
Active
Other names
MEDICINE SPECIALTY GROUP AT LICH
Organization subpart
No
Provider details
NPI number
Authorized official
VLADIMIR PRIVMAN MD (MANAGING EMPLOYEE)
(718) 780-2155
Entity
Organization
Contact information
Practice address
97 AMITY ST, BROOKLYN, NY 11201-6004
(718) 780-2155
Mailing address
160 WATER ST, 20FL, NEW YORK, NY 10038-4922
(212) 256-3682
(212) 256-3538
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02420102
—
NY
Enumeration date
05/27/2006
Last updated
11/03/2009
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