North Shore - Lij Health System

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

License

026037 Issued in NY

Legal business name

NORTH SHORE - LIJ HEALTH SYSTEM

Practice address

1554 Northern Blvd
PM&R
Manhasset, NY 11030-3006

Phone

(516) 627-8670

NPI assigned

Mar 23, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Justin Ettinger, MSPT

Title

Physical Therapist

Phone

(516) 627-8470

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295852192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 CORNWALL LN",
            "address_2": "APT A1J",
            "city": "CARLE PLACE",
            "state": "NY",
            "postal_code": "115141086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1554 NORTHERN BLVD",
            "address_2": "PM&R",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303006",
            "telephone_number": "516-627-8670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE - LIJ HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ETTINGER",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "516-627-8470",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSPT"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "NY",
            "license": "026037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zabeen Noorani, M.D.
• Diana Rachael Nordquist, MD
• Norh Shore Lij- Zucker Hillside Hospital
• North American Partners in Pain Management LLP
• North East Medical Diagnostics, PC
• North Shore - Lij Medical Group Urgent Medical Care, PC
• North Shore Complete Medical PC
• North Shore Faculty Medical Affiliates, University Faculty Prac
• North Shore Faculty Medical Affiliates, University Faculty Practice Co
• North Shore Faculty Medical Affiliates, University Faculty Practice Co

• Rehabilitation Clinic/Center in Manhasset, NY
• Providers in Manhasset, NY by specialty
• Rehabilitation Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.