Organization
LONG ISLAND JEWISH MEDICAL CENTER
Active
Other names
Long Island Jewish Community Residents Program
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELE LEE CUSACK (SENIOR VICE PRESIDENT & CFO)
(516) 876-1386
Entity
Organization
Contact information
Practice address
27005 76TH AVE, NEW HYDE PARK, NY 11040-1433
(516) 876-6000
(516) 876-6600
Mailing address
972 BRUSH HOLLOW RD, WESTBURY, NY 11590-1740
(516) 876-6000
(516) 876-6600
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1321493
—
NY
Enumeration date
11/20/2006
Last updated
11/28/2018
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