North Shore - Lij Internal Medicine At Lynbrook PC
Internal Medicine in Lynbrook, NY. Organization (NPI-2).
NPI number1568898138
StatusActive
Last updated in NPPESJul 25, 2022
Details
- NPI
- 1568898138
- Entity type
- Organization (NPI-2)
- Legal business name
- North Shore - Lij Internal Medicine At Lynbrook PC
- Organization subpart
- No
- Enumeration date
- Sep 16, 2013
- Certification date
- Jul 25, 2022
- Last updated
- Jul 25, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | – | – | Yes |
| 207RC0000X | Internal Medicine, Cardiovascular Disease | – | – | |
| 207RP1001X | Internal Medicine, Pulmonary Disease | – | – | |
| 207RG0100X | Internal Medicine, Gastroenterology | – | – |
Other names
- North Shore - Lij Medical Group South Shore Medical Associates (Doing Business As)
Practice location
158 Hempstead AveLynbrook, NY 11563-1605
Phone 516-593-3541 · Fax 516-599-8307
Mailing address
972 Brush Hollow RdFinance 5th Floor
Westbury, NY 11590-1740
Authorized official
Michele Cusak
Cfo
5165628182
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