Provider Demographics
NPI:1609090273
Name:LONG ISLAND JEWISH HOSPITAL
Entity Type:Organization
Organization Name:LONG ISLAND JEWISH HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AR CLERK
Authorized Official - Prefix:
Authorized Official - First Name:NADINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS-RAKINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-470-8650
Mailing Address - Street 1:400 LAKEVILLE ROAD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1110
Mailing Address - Country:US
Mailing Address - Phone:718-470-8650
Mailing Address - Fax:516-488-8520
Practice Address - Street 1:400 LAKEVILLE ROAD
Practice Address - Street 2:SUITE 150
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1110
Practice Address - Country:US
Practice Address - Phone:718-470-8650
Practice Address - Fax:516-488-8520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital