Provider Demographics
NPI:1932472107
Name:NORTH SHORE UNIVERSITY HOSPITAL
Entity Type:Organization
Organization Name:NORTH SHORE UNIVERSITY HOSPITAL
Other - Org Name:NSLIJHS MEDICAL HEALTH HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR VICE PRESIDENT & CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:L
Authorized Official - Last Name:CUSACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-321-6058
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 1:3333 NEW HYDE PARK RD STE 317
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1205
Practice Address - Country:US
Practice Address - Phone:516-472-3904
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-17
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management