| Organization Name: | LONG ISLAND JEWISH MEDICAL CENTER |
| NPI Number: | 1093723488 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROBERT S. SHAPIRO (SENIOR PRESIDENT & CFO) |
| Mailing Address: | 22022 Hillside Avenue Queens Village |
| State: | NY US |
| Postal Code: | 114272020 |
| Phone Number: | 5168766000 |
| Fax Number: | 5168766600 |
| NPI Enumeration Date: | 08/03/2006 |
| NPI Last Update Date: | 05/20/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QE0700X |
| License Number: | 7003004H |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
| Taxonomy Definition: | |