Healthcare Provider Details

I. General information

NPI: 1053615724
Provider Name (Legal Business Name): METROPOLITAN HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2011
Last Update Date: 01/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 1ST AVE
NEW YORK NY
10029-7404
US

IV. Provider business mailing address

1901 1ST AVE
NEW YORK NY
10029-7404
US

V. Phone/Fax

Practice location:
  • Phone: 212-423-6597
  • Fax: 212-423-7804
Mailing address:
  • Phone: 212-423-6597
  • Fax: 212-423-7804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberR048873-1
License Number StateNY

VIII. Authorized Official

Name: PRISCILLA SANTIAGO SR.
Title or Position: SUPV.V
Credential: LCSW
Phone: 646-672-3260