Healthcare Provider Details
I. General information
NPI: 1700805751
Provider Name (Legal Business Name): NEW YORK PRESBYTERIAN HOSPITAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/19/2006
Last Update Date: 02/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
525 E 68TH ST GREENBERG PAVILION RM 10-171
NEW YORK NY
10021-4870
US
IV. Provider business mailing address
PO BOX 27842
NEW YORK NY
10087-7842
US
V. Phone/Fax
- Phone: 212-746-0838
- Fax: 516-437-4167
- Phone: 718-670-1651
- Fax: 516-437-4167
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 133N00000X |
| Taxonomy | Nutritionist |
| License Number | 005425-1 |
| License Number State | NY |
VIII. Authorized Official
Name:
DORA
HARTOFILIS
Title or Position: DIRECTOR OF BILLING
Credential:
Phone: 718-661-8711