Provider Demographics
NPI:1437337847
Name:NORTHSHORE-LONG ISLAND JEWISH HEALTH SYSTEM
Entity Type:Organization
Organization Name:NORTHSHORE-LONG ISLAND JEWISH HEALTH SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:L
Authorized Official - Last Name:WHYTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-488-2662
Mailing Address - Street 1:126 COVERT AVE
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11003-1133
Mailing Address - Country:US
Mailing Address - Phone:516-852-9283
Mailing Address - Fax:
Practice Address - Street 1:200 COMMUNITY DR
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5504
Practice Address - Country:US
Practice Address - Phone:516-465-8855
Practice Address - Fax:516-465-8890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-07
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF334779282N00000X, 291U00000X, 302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No291U00000XLaboratoriesClinical Medical Laboratory
No302R00000XManaged Care OrganizationsHealth Maintenance Organization