Organization
NORTH SHORE-LIJ HEALTH PLAN
Active
Parent organization
NORTH SHORE-LIJ HEALTH PLAN HOLDING COMPANY
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTH SHORE-LIJ HEALTH PLAN HOLDING COMPANY
Authorized official
ROBERT BROWN (VICE PRESIDENT OF MANAGED CARE)
(516) 465-8106
Entity
Organization
Contact information
Practice address
145 COMMUNITY DR, GREAT NECK, NY 11021-5502
(516) 465-8106
Mailing address
145 COMMUNITY DR, GREAT NECK, NY 11021-5502
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1100089256
NYS VENDOR IDENTIFICATION
—
Enumeration date
06/21/2013
Last updated
07/01/2013
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