Provider Demographics
NPI:1477946408
Name:NORTH SHORE LIJ HEALTH SYSTEM
Entity Type:Organization
Organization Name:NORTH SHORE LIJ HEALTH SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUDARSHANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROYCHOUDHURY
Authorized Official - Suffix:
Authorized Official - Credentials:MBBS
Authorized Official - Phone:347-218-0198
Mailing Address - Street 1:6 OHIO DR
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1124
Mailing Address - Country:US
Mailing Address - Phone:516-304-7495
Mailing Address - Fax:
Practice Address - Street 1:6 OHIO DR
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1124
Practice Address - Country:US
Practice Address - Phone:516-304-7495
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-16
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital