Organization
LONG ISLAND JEWISH MEDICAL CENTER
Active
Parent organization
LONG ISLAND JEWISH MEDICAL CENTER
Other names
End Stage Renal Dialysis Facility
Organization subpart
Yes
Provider details
NPI number
Legal business name
LONG ISLAND JEWISH MEDICAL CENTER
Authorized official
MRS. MICHELE LEE CUSACK (SENIOR VICE PRESIDENT & CFO)
(516) 321-6058
Entity
Organization
Contact information
Practice address
22022 HILLSIDE AVENUE, QUEENS VILLAGE, NY 11427-2020
(516) 876-6000
(516) 876-6600
Mailing address
972 BRUSH HOLLOW RD, 5TH FLOOOR FINANCE, WESTBURY, NY 11590-1740
(516) 876-6000
(516) 876-6600
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
7003004H
NY
Other
Enumeration date
08/03/2006
Last updated
11/28/2018
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