Basic Information
| Provider Information | |||||||||
| NPI: | 1134376254 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JAMAICA HOSPITAL MEDICAL CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 425 E 63RD ST | ||||||||
| Address2: | E7A | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100657804 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 133-03 JAIMAICA AVE WOMENS HEALTH | ||||||||
| Address2: | JAMAICA HOSPITAL MEDICAL CENTER | ||||||||
| City: | RICHMOND HILL | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11418 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7182913276 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/20/2008 | ||||||||
| LastUpdateDate: | 08/20/2008 | ||||||||
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| AuthorizedOfficialLastName: | ALICEA | ||||||||
| AuthorizedOfficialFirstName: | JULIA | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | OB/GYN NURSE PRACTITIONER | ||||||||
| AuthorizedOfficialTelephone: | 7182913276 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | NP | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA0005X | 360335 | NY | Y | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Family Planning Facility |
No ID Information.