| Mary Immaculate Hospital | |
|
11449 Sutphin Blvd Jamaica NY 11434-1022 | |
| (718) 558-6622 | |
| Not Available |
| Full Name | Mary Immaculate Hospital |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 11449 Sutphin Blvd, Jamaica, New York |
| Authorized Official Name and Position | Marina Adelman (BILLING DEPARTMENT) |
| Authorized Official Contact | 7187437090 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mary Immaculate Hospital 15211 89th Ave Jamaica NY 11432-3730 Ph: (718) 743-7090 | Mary Immaculate Hospital 11449 Sutphin Blvd Jamaica NY 11434-1022 Ph: (718) 558-6622 |
| NPI Number | 1316041924 |
|---|---|
| Provider Enumeration Date | 09/12/2006 |
| Last Update Date | 12/21/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316041924 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 026852 (New York) | Primary |
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