Basic Information
Provider Information
NPI: 1649705633
EntityType: 2
ReplacementNPI:  
OrganizationName: NEW YORK PRESBYTERIAN-QUEENS
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5645 MAIN ST
Address2:  
City: FLUSHING
State: NY
PostalCode: 113555045
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 5645 MAIN ST
Address2:  
City: FLUSHING
State: NY
PostalCode: 113555045
CountryCode: US
TelephoneNumber: 7186701231
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/27/2017
LastUpdateDate: 04/27/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: LANTOS
AuthorizedOfficialFirstName: PHYLLIS
AuthorizedOfficialMiddleName: R.F
AuthorizedOfficialTitleorPosition: EVP, CFO AND TREASURER
AuthorizedOfficialTelephone: 2127467905
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MRS.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
282N00000X  Y HospitalsGeneral Acute Care Hospital 

No ID Information.


Home