MARY IMMACULATE HOSPITAL (NPI# 1245364223) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245364223 |
| Entity Type | Organization |
| Organization Name | MARY IMMACULATE HOSPITAL |
| Practice Address |
24 Night Heron Dr Stony Brook NY 11790-1108 |
| Mailing Address |
152-11 89th Ave. Mary Immaculate Hospital Jamaica NY 11432-1108 |
| Practice Telephone | 6316895654 |
| Practice Fax Number | 7185582166 |
| Mailing Telephone | 7185582714 |
| Mailing Fax Number | 7185582166 |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. USHA C RUDER (CHAIR, PATHOLOGY DEPARTMENT) |
| Authorized Official Telephone | 7155582714 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
115646 | NY | Hospitals |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629414867 | Mary Immaculate Hospital | Pharmacy | 12720 Mcmanus Blvd Ste 100, Newport News, VA 23602-4414 | 2013-05-15 |
| 1316041924 | Mary Immaculate Hospital | Dentist | 11449 Sutphin Blvd, Jamaica, NY 11434-1022 | 2006-09-12 |
| 1194267229 | Mary Immaculate Hospital | Obstetrics & Gynecology | 12720 Mcmanus Blvd, Suite 301, Newport News, VA 23602-4414 | 2016-11-07 |
| 1689047979 | Mary Immaculate Hospital | Surgery | 12720 Mcmanus Blvd, Suite 203, Newport News, VA 23602-4414 | 2015-11-09 |
| 1356625073 | Mary Immaculate Hospital | Internal Medicine | 12720 Mcmanus Blvd, Suite 303, Newport News, VA 23602-4414 | 2011-09-29 |
| 1265715932 | Mary Immaculate Hospital | Obstetrics & Gynecology | 500 Sentara Cir, Suite 102, Williamsburg, VA 23188-5727 | 2011-09-20 |
| 1578841367 | Mary Immaculate Hospital | Internal Medicine | 885 Kempsville Rd, Suite 320, Norfolk, VA 23502-3800 | 2011-07-27 |
| 1962719666 | Mary Immaculate Hospital | Surgery | 2 Bernardine Dr, Newport News, VA 23602-4404 | 2010-09-02 |
| 1003130394 | Mary Immaculate Hospital | Internal Medicine | 12720 Mcmanus Blvd, Suite 201, Newport News, VA 23602-4414 | 2010-03-16 |
| 1164685129 | Mary Immaculate Hospital | Clinic/Center | 14703 Warwick Blvd, Suite A, Newport News, VA 23608-3611 | 2008-07-09 |
| Street Address |
24 NIGHT HERON DR |
| City | STONY BROOK |
| State | NY |
| Zip Code | 11790-1108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649807678 | Ribu Mathew | Student in an Organized Health Care Education/Training Program | Health Science Center T16, Room 020, Stony Brook, NY 11790 | 2020-03-27 |
| 1538794821 | Chaoyang Qu | Student in an Organized Health Care Education/Training Program | 9 Syncamore Dr, Stonybrook, NY 11790 | 2020-03-06 |
| 1457814824 | Brain & Spine Surgery, P.C. | Neurological Surgery | 2500 Nesconset Hwy., Bldg 18c, Stony Brook, NY 11790 | 2019-04-11 |
| 1447759741 | Susan Cuccia | Registered Nurse | 40 Sheppard Lane, Stony Brook, NY 11790 | 2018-02-02 |
| 1972022234 | Carol M Doherty | Specialist | 7 Haskel Lane, Stony Brook, NY 11790 | 2017-09-18 |
| 1972021582 | Louren M Gonzales | Nurse Practitioner | 100 Nicolls Rd Hsc Level 4 Room 120, Hsc Level 4 Room 120, Stony Brook, NY 11790 | 2017-09-04 |
| 1043740954 | Asma Khattak | Behavior Technician | 90 Quaker Path, Stony Brook, NY 11790 | 2017-06-13 |
| 1427452846 | Christina Georgia | Registered Nurse | 36 Ivy League Lane, Stony Brook, NY 11790 | 2014-10-14 |
| 1124361654 | Mandeep Kainth | Student in an Organized Health Care Education/Training Program | Department of Medicine Hsc Level 16, 020, Suny Stony Brook, Stony Brook, NY 11790 | 2013-04-03 |
| 1922357144 | Audry M Luciano | Registered Nurse | 2500 Nesconset Hwy Bldg 23, Stony Brook, NY 11790 | 2012-09-04 |
| Find all providers in zip 11790 | ||||
| Taxonomy Code | 282NC0060X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Critical Access |
| Definition to come. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215181680 | Stony Brook University Hospital | General Acute Care Hospital | Stony Brook Hospital Nicholls Rd, Cardiology Department, Stony Brook, NY 11794-0001 | 2008-11-11 |
| 1942417399 | Stony Brook Medical Center | General Acute Care Hospital | T 19 Hsc Rm 080, Stony Brook, NY 11794-8191 | 2007-05-16 |
| 1255548699 | Stony Brook Medical Center | General Acute Care Hospital | T19 080 Health Sciences Ctr, Stony Brook, NY 11794-0001 | 2007-05-16 |
| 1225023963 | University Hospital Stony Brook | General Acute Care Hospital | University Medical Center, Division of Cardiothoracic Surgery T19,hsc, Room 080, Stony Brook, NY 11794-0001 | 2005-09-19 |
| 1679626063 | Stony Brook University Medical Center | General Acute Care Hospital | Nicolls Rd, Stony Brook, NY 11794-0001 | 2007-01-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740658277 | Saint Barnabas Health System | General Acute Care Hospital | 2132 Wallace Ave, Apt-242, Bronx, NY 10462-2573 | 2015-09-15 |
| 1124412101 | Matthew Scott Stephany | General Acute Care Hospital | 356 Brush Creek Dr, Rochester, NY 14612-2270 | 2015-03-26 |
| 1235522764 | Lei Meng | General Acute Care Hospital | 39 Claremont Ave, Apt 82, New York, NY 10027 | 2015-03-09 |
| 1225437650 | 37th Ave Pharmacy Inc | General Acute Care Hospital | 9507 37th Ave, Jackson Heights, NY 11372-8024 | 2014-08-21 |
| 1326454372 | Liza John | General Acute Care Hospital | 97 Beaumont Cir, Apt-1, Yonkers, NY 10710-2032 | 2014-07-09 |
| 1699106187 | Nslij | General Acute Care Hospital | 1999 Marcus Ave Ste 106c, New Hyde Park, NY 11042-1028 | 2013-12-09 |
| 1588005466 | Newyork Presbyterian Hospital | General Acute Care Hospital | 109 Alpine Rd, Yonkers, NY 10710-2022 | 2013-07-08 |
| 1548601578 | New York Community Hospital, Brooklyn | General Acute Care Hospital | 8922 133rd St, 2nd Floor, Richmond Hill, NY 11418-2813 | 2013-07-06 |
| 1144565177 | Suny Downstate Medical Center | General Acute Care Hospital | 2 Fuschetto Ct, Farmingdale, NY 11735-4262 | 2012-12-03 |
| 1417205931 | Harlem Hospital | General Acute Care Hospital | 506 Lenox Avenue, 14th Floor, Room 106, New York, NY 10037 | 2012-08-15 |
| Find all providers with the same taxonomy | ||||
| City | STONY BROOK |
| Zip Code | 11790 |
Please comment or provide details below to improve the information on MARY IMMACULATE HOSPITAL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.