Healthcare Provider Details

I. General information

NPI: 1992701205
Provider Name (Legal Business Name): ST LUKES ROOSEVELT HOSPITAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2005
Last Update Date: 01/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 WEST 59TH STREET, STE 9-B
NEW YORK NY
10019-1104
US

IV. Provider business mailing address

PO BOX 95000-2239
PHILADELPHIA PA
19195-2239
US

V. Phone/Fax

Practice location:
  • Phone: 212-523-7752
  • Fax: 212-523-7731
Mailing address:
  • Phone: 732-873-5133
  • Fax: 732-873-6858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY SINGERMAN
Title or Position: ADMINISTRATOR
Credential:
Phone: 212-523-3452