Basic Information
| Provider Information | |||||||||
| NPI: | 1477706182 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LONG ISLAND JEWISH HEALTH SYSTEM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16 MAPLE WING DR | ||||||||
| Address2: | |||||||||
| City: | CENTRAL ISLIP | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117224600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6312978499 | ||||||||
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| Practice Location | |||||||||
| Address1: | 200 COMMUNITY DR | ||||||||
| Address2: | |||||||||
| City: | GREAT NECK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 110215504 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7184707000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/24/2008 | ||||||||
| LastUpdateDate: | 10/24/2008 | ||||||||
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| AuthorizedOfficialLastName: | RUMPLICK | ||||||||
| AuthorizedOfficialFirstName: | CYNTHIA | ||||||||
| AuthorizedOfficialMiddleName: | MARIE | ||||||||
| AuthorizedOfficialTitleorPosition: | CERTIFIED NURSE MIDWIFE | ||||||||
| AuthorizedOfficialTelephone: | 5164658855 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | CNM NP OB/GYN | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | F360447-1 | NY | N | Hospitals | General Acute Care Hospital | 282N00000X | F001052-1 | NY | Y | Hospitals | General Acute Care Hospital |
No ID Information.