Provider Demographics
NPI:1740610757
Name:NORTH SHORE LONG ISLAND JEWISH HEALTH CARE INC
Entity Type:Organization
Organization Name:NORTH SHORE LONG ISLAND JEWISH HEALTH CARE INC
Other - Org Name:NORTH SHORE-LIJ MEDICAL GROUP MITCHELL BOXER
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE VP & CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:S
Authorized Official - Last Name:SHAPIRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-465-8182
Mailing Address - Street 1:972 BRUSH HOLLOW RD
Mailing Address - Street 2:FINANCE 5TH FLOOR
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-1740
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2001 MARCUS AVE
Practice Address - Street 2:SUITE N220
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-2061
Practice Address - Country:US
Practice Address - Phone:516-482-0910
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-13
Last Update Date:2013-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty