Organization
MARY IMMACULATE HOSPITAL
Active
Organization
MARY IMMACULATE HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARINA ADELMAN (BILLING DEPARTMENT)
(718) 743-7090
Entity
Organization
Contact information
Practice address
11449 SUTPHIN BLVD, JAMAICA, NY 11434-1022
(718) 558-6622
Mailing address
15211 89TH AVE, JAMAICA, NY 11432-3730
(718) 743-7090
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
026852
NY
Other
Enumeration date
09/12/2006
Last updated
12/21/2007
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