Provider Demographics
NPI:1881827301
Name:NORTH SHORE LIJ
Entity Type:Organization
Organization Name:NORTH SHORE LIJ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WOLF KLEIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GISELLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-470-7000
Mailing Address - Street 1:3 DRURY LN
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-6604
Mailing Address - Country:US
Mailing Address - Phone:516-390-9321
Mailing Address - Fax:
Practice Address - Street 1:3 DRURY LN
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-6604
Practice Address - Country:US
Practice Address - Phone:516-390-9321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-01
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital