Healthcare Provider Details

I. General information

NPI: 1215240148
Provider Name (Legal Business Name): ST. LUKE'S ROOSEVELT HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2010
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 E 50TH ST APARTMENT 9E
NEW YORK NY
10022-7936
US

IV. Provider business mailing address

319 E 50TH ST APARTMENT 9E
NEW YORK NY
10022-7936
US

V. Phone/Fax

Practice location:
  • Phone: 973-255-9819
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code284300000X
TaxonomySpecial Hospital
License Number
License Number StateNY

VIII. Authorized Official

Name: DR. BRIAN WOSNITZER
Title or Position: RESIDENT
Credential: M.D.
Phone: 973-255-9819