Provider Demographics
NPI:1689958779
Name:NEWYORK-PRESBYTERIAN-QUEENS
Entity Type:Organization
Organization Name:NEWYORK-PRESBYTERIAN-QUEENS
Other - Org Name:TRANSITIONAL CARE UNIT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EVP, CFO & TREASURER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PHYLLIS
Authorized Official - Middle Name:RF
Authorized Official - Last Name:LANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-746-7905
Mailing Address - Street 1:5645 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-5045
Mailing Address - Country:US
Mailing Address - Phone:718-670-2000
Mailing Address - Fax:718-670-1002
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:718-670-2000
Practice Address - Fax:718-670-1002
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NYP COMMUNITY PROGRAMS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-10-06
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY335862OtherMEDICARE PTAN