Healthcare Provider Details

I. General information

NPI: 1487857744
Provider Name (Legal Business Name): NEW YORK-PRESBYTERIAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 E 74TH ST
NEW YORK NY
10021-3712
US

IV. Provider business mailing address

300 E 74TH ST
NEW YORK NY
10021-3712
US

V. Phone/Fax

Practice location:
  • Phone: 212-772-7558
  • Fax:
Mailing address:
  • Phone: 212-772-7558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code281P00000X
TaxonomyChronic Disease Hospital
License Number006211-1
License Number StateNY

VIII. Authorized Official

Name: MS. MARY MARGARET LAWLOR
Title or Position: PHYSICIAN ASSISTANT
Credential: PA
Phone: 212-305-2500