Provider Demographics
NPI:1336301985
Name:NEW YORK HOSPITAL OF QUEENS
Entity Type:Organization
Organization Name:NEW YORK HOSPITAL OF QUEENS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LACREASIA
Authorized Official - Middle Name:KORSHANNA
Authorized Official - Last Name:WHEAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-670-9911
Mailing Address - Street 1:3415 PARSONS BLVD
Mailing Address - Street 2:APARTMENT 6HH
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-4638
Mailing Address - Country:US
Mailing Address - Phone:412-867-9911
Mailing Address - Fax:
Practice Address - Street 1:3415 PARSONS BLVD
Practice Address - Street 2:APARTMENT 6HH
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-4638
Practice Address - Country:US
Practice Address - Phone:412-867-9911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-25
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes281P00000XHospitalsChronic Disease Hospital