Healthcare Provider Details

I. General information

NPI: 1831286145
Provider Name (Legal Business Name): SAINT VINCENT CATHOLIC MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 07/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

153 W 11TH ST
NEW YORK NY
10011-8305
US

IV. Provider business mailing address

450 W 33RD ST
NEW YORK NY
10001-2603
US

V. Phone/Fax

Practice location:
  • Phone: 212-604-7000
  • Fax: 212-356-4439
Mailing address:
  • Phone: 212-356-4419
  • Fax: 212-356-4439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number7002037H
License Number StateNY

VIII. Authorized Official

Name: MS. DOLLYANN L YORKE
Title or Position: DIRECTOR OF REIMBURSEMENT
Credential:
Phone: 212-356-4419