| Mary Immaculate Hospital | |
|
152-11 89th Avenue Jamaica NY 11432-3730 | |
| (718) 558-2000 | |
| (718) 558-2425 |
| Full Name | Mary Immaculate Hospital |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 152-11 89th Avenue, Jamaica, New York |
| Authorized Official Name and Position | Richard J Sarli (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 7188302712 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mary Immaculate Hospital 95-25 Queens Boulevard 3rd Floor Rego Park NY 11374-4511 Ph: (718) 830-2711 | Mary Immaculate Hospital 152-11 89th Avenue Jamaica NY 11432-3730 Ph: (718) 558-2000 |
| NPI Number | 1811155658 |
|---|---|
| Provider Enumeration Date | 05/29/2008 |
| Last Update Date | 08/11/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811155658 | NPI | - | NPPES |
| 00243861 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 7003027H (New York) | Primary |
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