Healthcare Provider Details

I. General information

NPI: 1942468855
Provider Name (Legal Business Name): BETH ISRAEL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2008
Last Update Date: 05/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 UNION SQ E 2Q
NEW YORK NY
10003-3314
US

IV. Provider business mailing address

10 UNION SQ E 2Q
NEW YORK NY
10003-3314
US

V. Phone/Fax

Practice location:
  • Phone: 212-844-6897
  • Fax:
Mailing address:
  • Phone: 212-844-6897
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number State

VIII. Authorized Official

Name: DR. DANIEL MAC GOWAN
Title or Position: NEUROLOGIST RESIDENCY PROGRAM DIR
Credential: MD MRCP
Phone: 212-844-6897