Healthcare Provider Details

I. General information

NPI: 1366426389
Provider Name (Legal Business Name): BETH ISRAEL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2005
Last Update Date: 08/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 UNION SQ E SUITE 3A
NEW YORK NY
10003-3314
US

IV. Provider business mailing address

160 WATER ST
NEW YORK NY
10038-4922
US

V. Phone/Fax

Practice location:
  • Phone: 212-844-8900
  • Fax:
Mailing address:
  • Phone: 212-844-8900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number127892
License Number StateNY

VIII. Authorized Official

Name: HARRIS NAGLER
Title or Position: DEPT CHAIR
Credential: MD
Phone: 212-844-8900