Healthcare Provider Details

I. General information

NPI: 1679641237
Provider Name (Legal Business Name): NORTHERN WESTCHESTER HOSPITAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 12/06/2013
Certification Date:
Deactivation Date: 03/27/2007
Reactivation Date: 05/21/2008

III. Provider practice location address

400 E MAIN ST
MOUNT KISCO NY
10549-3417
US

IV. Provider business mailing address

400 EAST MAIN STREET NORTHERN WESTCHESTER HOSPITAL MEDICAL AFFAIRS OFFICE
MT KISCO NY
10549
US

V. Phone/Fax

Practice location:
  • Phone: 914-666-1254
  • Fax: 914-666-1931
Mailing address:
  • Phone: 914-242-8318
  • Fax: 914-666-1965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number5920000H
License Number StateNY

VIII. Authorized Official

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