Provider Demographics
NPI:1609171875
Name:NSLIJ HEALTH SYSTEM
Entity Type:Organization
Organization Name:NSLIJ HEALTH SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERNAL MEDICINE
Authorized Official - Prefix:MRS
Authorized Official - First Name:GISELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLF-KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-470-7295
Mailing Address - Street 1:16 GLENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-2412
Mailing Address - Country:US
Mailing Address - Phone:347-206-1532
Mailing Address - Fax:
Practice Address - Street 1:16 GLENWOOD AVE
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-2412
Practice Address - Country:US
Practice Address - Phone:347-206-1532
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-20
Last Update Date:2013-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY263640282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital