Basic Information
Provider Information
NPI: 1487956983
EntityType: 2
ReplacementNPI:  
OrganizationName: LENOX HILL HOSPITAL
LastName:  
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Mailing Information
Address1: 972 BRUSH HOLLOW RD FL 5
Address2:  
City: WESTBURY
State: NY
PostalCode: 115901740
CountryCode: US
TelephoneNumber: 5168766065
FaxNumber: 5168765572
Practice Location
Address1: 210 E 64TH ST
Address2:  
City: NEW YORK
State: NY
PostalCode: 10065
CountryCode: US
TelephoneNumber: 2127027305
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/03/2010
LastUpdateDate: 07/23/2018
NPIDeactivationReasonCode:  
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ProviderGenderCode:  
AuthorizedOfficialLastName: CUSACK
AuthorizedOfficialFirstName: MICHELE
AuthorizedOfficialMiddleName: LEE
AuthorizedOfficialTitleorPosition: SENIOR VICE PRESIDENT & CFO
AuthorizedOfficialTelephone: 5163216058
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MRS.
AuthorizedOfficialNameSuffix:  
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NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
283Q00000X0186111NYY HospitalsPsychiatric Hospital 

No ID Information.


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