Provider Demographics
NPI:1619360831
Name:NEW YORK HOSPITAL MEDICAL CENTER OF QUEENS
Entity Type:Organization
Organization Name:NEW YORK HOSPITAL MEDICAL CENTER OF QUEENS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR PA
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:SUNGKWAN
Authorized Official - Last Name:NGAI-TSANG
Authorized Official - Suffix:
Authorized Official - Credentials:RPA-C, MS
Authorized Official - Phone:718-661-7266
Mailing Address - Street 1:1955 LAKEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-1972
Mailing Address - Country:US
Mailing Address - Phone:516-616-0716
Mailing Address - Fax:
Practice Address - Street 1:5645 MAIN ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-5045
Practice Address - Country:US
Practice Address - Phone:718-670-1572
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-12
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002580-1282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital