Organization
LONG ISLAND JEWISH MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL DWYER (ASSOCIATE EXECUTIVE DIRECTOR)
(718) 470-3521
Entity
Organization
Contact information
Practice address
7559 263RD STREET @ 74TH AVENUE, GLEN OAKS, NY 11004-1050
(718) 470-4834
Mailing address
7559 263RD ST, GLEN OAKS, NY 11004-1150
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
282N00000X
General Acute Care Hospital
—
—
282NC2000X
Children's Hospital
—
—
Other
Enumeration date
01/30/2015
Last updated
01/30/2015
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