1366460826 NPI number — NEW YORK HOSPITAL MEDICAL CENTER OF QUEENS

Table of content: (NPI 1366460826)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366460826 NPI number — NEW YORK HOSPITAL MEDICAL CENTER OF QUEENS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW YORK HOSPITAL MEDICAL CENTER OF QUEENS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
EMERGENCY PRACTICE PLAN
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1366460826
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 430
Provider Second Line Business Mailing Address:
EMERGENCY PRACTICE PLAN
Provider Business Mailing Address City Name:
FLUSHING
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11352-0430
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-668-6491
Provider Business Mailing Address Fax Number:
610-617-6280

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
56-45 MAIN STREET
Provider Second Line Business Practice Location Address:
NYHMQ EMERGENCY DEPARTMENT
Provider Business Practice Location Address City Name:
FLUSHING
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11355
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-670-1426
Provider Business Practice Location Address Fax Number:
610-617-6280
Provider Enumeration Date:
07/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SIXSMITH
Authorized Official First Name:
DIANE
Authorized Official Middle Name:
Authorized Official Title or Position:
DEPARTMENT CHAIRMAN
Authorized Official Telephone Number:
718-670-1426

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00825838 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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