Provider Demographics
NPI:1043362791
Name:ST JOHN'S HOSPITAL
Entity type:Organization
Organization Name:ST JOHN'S HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL COUNCILOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NALINE
Authorized Official - Middle Name:
Authorized Official - Last Name:GOKUL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-558-1133
Mailing Address - Street 1:9002 QUEENS BLVD
Mailing Address - Street 2:ELMHURST
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4941
Mailing Address - Country:US
Mailing Address - Phone:718-558-1133
Mailing Address - Fax:718-558-1945
Practice Address - Street 1:9002 QUEENS BLVD
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-4941
Practice Address - Country:US
Practice Address - Phone:718-558-1133
Practice Address - Fax:718-558-1945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital