Organization
LONG ISLAND COLLEGE HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIJAY JOHN MANI MD (CHAIRMAN, ORTHOPEDICS DEPT.)
(718) 780-4705
Entity
Organization
Contact information
Practice address
97 AMITY STREET, BROOKLYN, NY 11201
(718) 780-4705
(718) 780-1396
Mailing address
97 AMITY STREET, BROOKLYN, NY 11201
(718) 780-4705
(718) 780-1396
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
003327-1
NY
363A00000X
Physician Assistant
003327 1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003327-1
LICENSE #
NY
Enumeration date
04/10/2007
Last updated
08/06/2008
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