Provider Demographics
NPI:1740354166
Name:HOSPICE CARE NETWORK
Entity type:Organization
Organization Name:HOSPICE CARE NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TANVEER
Authorized Official - Middle Name:P
Authorized Official - Last Name:MIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-832-7100
Mailing Address - Street 1:100 SHORE ROAD
Mailing Address - Street 2:
Mailing Address - City:COLD SPRING HARBOR
Mailing Address - State:NY
Mailing Address - Zip Code:11724
Mailing Address - Country:US
Mailing Address - Phone:631-692-2450
Mailing Address - Fax:
Practice Address - Street 1:99 SUNNYSIDE BLVD
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NY
Practice Address - Zip Code:11797-2901
Practice Address - Country:US
Practice Address - Phone:516-832-7100
Practice Address - Fax:516-832-7160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY179063207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF73069Medicare UPIN