Provider Demographics
NPI:1750459046
Name:LONG ISLAND JEWISH MEDICAL CENTER
Entity Type:Organization
Organization Name:LONG ISLAND JEWISH MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN ASSISTANT
Authorized Official - Prefix:MISS
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:RUZOL
Authorized Official - Last Name:AMARGA
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:718-470-7000
Mailing Address - Street 1:1060 PLANDOME RD
Mailing Address - Street 2:
Mailing Address - City:PLANDOME
Mailing Address - State:NY
Mailing Address - Zip Code:11030-1033
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:27005 76TH AVE
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-1433
Practice Address - Country:US
Practice Address - Phone:718-470-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011215282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital