Organization
NORTH SHORE LIJ MEDICAL GROUP AT NORTH NASSAU, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELE CUSAK (CFO)
(516) 465-8182
Entity
Organization
Contact information
Practice address
70 GLEN ST, SUITE 200, GLEN COVE, NY 11542-2855
(516) 484-7893
Mailing address
972 BRUSH HOLLOW RD, FINANCE 5TH FLOOR, WESTBURY, NY 11590-1740
(516) 876-6065
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Enumeration date
04/05/2011
Last updated
07/26/2022
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