Healthcare Provider Details

I. General information

NPI: 1114334000
Provider Name (Legal Business Name): NORWALK HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2014
Last Update Date: 07/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 W 85TH ST APARTMENT 2B
NEW YORK NY
10024-4120
US

IV. Provider business mailing address

61 W 85TH ST APARTMENT 2B
NEW YORK NY
10024-4120
US

V. Phone/Fax

Practice location:
  • Phone: 203-247-1123
  • Fax:
Mailing address:
  • Phone: 203-247-1123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number672928-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number672928-1
License Number StateNY

VIII. Authorized Official

Name: KATHY DUNN
Title or Position: MANAGER, CP3
Credential: BS, RN
Phone: 203-852-2265