Provider Demographics
NPI:1750423885
Name:JAMAICA HOSPITAL MEDICAL CENTER
Entity type:Organization
Organization Name:JAMAICA HOSPITAL MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:P
Authorized Official - Last Name:ROSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-206-6290
Mailing Address - Street 1:9120 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11416-1527
Mailing Address - Country:US
Mailing Address - Phone:718-641-8207
Mailing Address - Fax:718-323-0414
Practice Address - Street 1:9120 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11416-1527
Practice Address - Country:US
Practice Address - Phone:718-641-8207
Practice Address - Fax:718-323-0414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7003003H261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02706081Medicaid
NY02706081Medicaid
NY0105VJMedicare ID - Type Unspecified