Provider Demographics
NPI:1851439962
Name:NORTH SHORE EMERGENCY MEDICINE AT PLAINVIEW
Entity Type:Organization
Organization Name:NORTH SHORE EMERGENCY MEDICINE AT PLAINVIEW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OF ER
Authorized Official - Prefix:DR
Authorized Official - First Name:GERARD
Authorized Official - Middle Name:X
Authorized Official - Last Name:BROGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-719-2484
Mailing Address - Street 1:888 OLD COUNTRY RD
Mailing Address - Street 2:EMERGENCY DEPT
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-4914
Mailing Address - Country:US
Mailing Address - Phone:516-719-2484
Mailing Address - Fax:
Practice Address - Street 1:888 OLD COUNTRY RD
Practice Address - Street 2:EMERGENCY DEPT
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-4914
Practice Address - Country:US
Practice Address - Phone:516-719-2484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY238023146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Single Specialty