Healthcare Provider Details

I. General information

NPI: 1457789075
Provider Name (Legal Business Name): NORTHERN WESTCHESTER HOSPITAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2013
Last Update Date: 10/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 EAST MAIN STREET 4TH FLOOR
MOUNT KISCO NY
10549-0000
US

IV. Provider business mailing address

400 EAST MAIN STREET MEDICAL AFFAIRS OFFICE
MOUNT KISCO NY
10549-0000
US

V. Phone/Fax

Practice location:
  • Phone: 914-666-1200
  • Fax: 914-666-1965
Mailing address:
  • Phone: 914-666-1279
  • Fax: 914-666-1965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN PARTENZA
Title or Position: CFO
Credential: CFO
Phone: 914-666-1310