NPIMap

Organization Active NPI

New York-Presbyterian-Queens

Doing business as NYP-Queens Diagnostic Lab

  • Clinical Medical Laboratory
  • Flushing, NY
National Provider Identifier
1053429274
Registry record updated Oct 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
NEW YORK-PRESBYTERIAN-QUEENS
Doing business as
NYP-Queens Diagnostic Lab
Practice address
5645 Main St
Flushing, NY 11355-5045
Phone
(718) 670-1651
NPI assigned
Aug 28, 2006
Last updated
Oct 19, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dora Hartofilis
Title
Director, Physician Billing
Phone
(718) 661-8711

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NU Primary
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X NU

Addresses

Primary practice location

5645 Main St
Flushing, NY 11355-5045

Mailing address

PO Box 27842
New York, NY 10087-7842
Phone (718) 670-1651

Other identifiers 1

IdentifierTypeStateIssuer
00244133MedicaidNY

Other names 1

  • NYP-Queens Diagnostic Lab Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110325000014 NY Part A Provider - Hospital 7315839933 3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jamaica, NY; Jackson Heights, NY; Fresh Meadows, NY; Flushing, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1053429274. Details of each certification follow.

Hospital certification: CCN 330055

Legal name
NEWYORK-PRESBYTERIAN-QUEENS
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Apr 18, 2025
Beds
535
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
May 22, 1973 in NY
Enrollment address
56-45 Main St
Flushing, NY 11355-5045
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
New York-Presbyterian/QueensCCN 330055 · All quality measures
Overall star rating
5 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Joseph Ficalora Individual Corporate DirectorBoard Member Apr 1, 2010
Kanak Golia Individual Corporate DirectorBoard Member Jan 1, 2017
William J Farrell Individual Corporate OfficerSenior Vice President, Finance, Jan 1, 2018
Pavlos L Mavrides Individual Corporate DirectorBoard of Directors Jan 1, 2017
Nyp Community Programs Inc Organization, New York, NY Created for acquisition, Corporation, Holding company, Non-profit Other Jul 1, 2015
Michael Breslin Individual Corporate Director Jul 1, 2022
W-2 Managing EmployeeChief Financial Officer Jul 1, 2022
Veronica Tsang Individual Corporate Director May 17, 2021
The New York and Presbyterian Hospital Organization, New York, NY Corporation, Non-profit Other Jul 1, 2015
Michael Mattone Individual Corporate Director Feb 19, 2019
Purvi D Shah Individual Corporate DirectorBoard Director Dec 1, 2025
Michael Meyer Individual Corporate DirectorBoard Member Jan 1, 2017
Arthur Dawson Individual Corporate DirectorBoard Member Jul 14, 1998
Wen-Hui Chiang Individual Corporate DirectorBoard Member Dec 1, 2004
Lauren McManemin Individual W-2 Managing EmployeeVendor Management Director Apr 1, 2018

Owners & managing parties with NPI records 7

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Affiliated clinicians 701

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 701

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445212800000",
    "number": "1053429274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27842",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100877842",
            "telephone_number": "718-670-1651",
            "fax_number": "516-437-4167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5645 MAIN ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113555045",
            "telephone_number": "718-670-1651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW YORK-PRESBYTERIAN-QUEENS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-28",
        "last_updated": "2015-10-19",
        "status": "A",
        "authorized_official_last_name": "HARTOFILIS",
        "authorized_official_first_name": "DORA",
        "authorized_official_title_or_position": "DIRECTOR, PHYSICIAN BILLING",
        "authorized_official_telephone_number": "718-661-8711"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00244133",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NYP-Queens Diagnostic Lab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.