Healthcare Provider Details

I. General information

NPI: 1356528756
Provider Name (Legal Business Name): NY PRESBYTERIAN HOSPITAL, COLUMBIA UNIVERSITY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2008
Last Update Date: 01/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

622 W 168TH ST PH12
NEW YORK NY
10032-3720
US

IV. Provider business mailing address

622 W 168TH ST PH12
NEW YORK NY
10032-3720
US

V. Phone/Fax

Practice location:
  • Phone: 212-342-3926
  • Fax:
Mailing address:
  • Phone: 212-342-3926
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code281P00000X
TaxonomyChronic Disease Hospital
License NumberF335023
License Number StateNY

VIII. Authorized Official

Name: MRS. MAUREEN GAINE
Title or Position: NURSE PRACTITIONER
Credential: NP
Phone: 212-342-3926