Provider Demographics
NPI:1811229206
Name:LONG ISLAND COLLEGE HOSPITAL
Entity Type:Organization
Organization Name:LONG ISLAND COLLEGE HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHARIMAN
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:HERSHBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:718-780-1065
Mailing Address - Street 1:444 E 57TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-3522
Mailing Address - Country:US
Mailing Address - Phone:212-223-8181
Mailing Address - Fax:212-223-8181
Practice Address - Street 1:444 E 57TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-3522
Practice Address - Country:US
Practice Address - Phone:212-223-8181
Practice Address - Fax:212-223-8181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-10
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5131992DUP273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit