Healthcare Provider Details

I. General information

NPI: 1407136609
Provider Name (Legal Business Name): ST. BARNABUS HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2011
Last Update Date: 08/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 E 188TH ST 5TH FLOOR
BRONX NY
10458-5302
US

IV. Provider business mailing address

61 W 62ND ST 8J
NEW YORK NY
10023-7015
US

V. Phone/Fax

Practice location:
  • Phone: 718-960-3382
  • Fax: 718-933-2502
Mailing address:
  • Phone: 347-631-7045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SCOTT COOPER
Title or Position: PRESIDENT, CEO
Credential: M.D.
Phone: 718-960-9000