Provider Demographics
NPI:1629423009
Name:NYU LANGONE MEDICAL CENTER/TISCH HOSPITAL
Entity Type:Organization
Organization Name:NYU LANGONE MEDICAL CENTER/TISCH HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT PROFESSOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:MANKO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-562-4317
Mailing Address - Street 1:70 PROVINCE DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11720-4617
Mailing Address - Country:US
Mailing Address - Phone:516-395-4194
Mailing Address - Fax:
Practice Address - Street 1:70 PROVINCE DR
Practice Address - Street 2:
Practice Address - City:SOUTH SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11720-4617
Practice Address - Country:US
Practice Address - Phone:516-395-4194
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-04
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital