Organization
MARY IMMACULATE HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. USHA C RUDER (CHAIPERSON)
(718) 558-2701
Entity
Organization
Contact information
Practice address
15211 89TH AVE, JAMAICA, NY 11432-3730
(718) 558-2701
Mailing address
45 BARRYPARK CT, ALBERTSON, NY 11507-1501
(516) 741-5465
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
181564
NY
Other
Enumeration date
04/09/2007
Last updated
08/22/2020
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