Provider Demographics
NPI:1225176175
Name:JAMAICA HOSPITAL MEDICAL CENTER
Entity Type:Organization
Organization Name:JAMAICA HOSPITAL MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VP AND CFO
Authorized Official - Prefix:
Authorized Official - First Name:MOUNIR
Authorized Official - Middle Name:
Authorized Official - Last Name:DOSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-206-6291
Mailing Address - Street 1:11120 MERRICK BLVD
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11433-4016
Mailing Address - Country:US
Mailing Address - Phone:718-206-9888
Mailing Address - Fax:718-206-3033
Practice Address - Street 1:13420 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11418-2619
Practice Address - Country:US
Practice Address - Phone:718-206-6980
Practice Address - Fax:718-206-8709
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JAMAICA HOSPITAL MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-02
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00243852Medicaid