Healthcare Provider Details

I. General information

NPI: 1811221245
Provider Name (Legal Business Name): NYU LANGONE MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2009
Last Update Date: 10/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

560 1ST AVE TISCH 8W
NEW YORK NY
10016-6402
US

IV. Provider business mailing address

560 1ST AVE TISCH 8W
NEW YORK NY
10016-6402
US

V. Phone/Fax

Practice location:
  • Phone: 212-263-0593
  • Fax: 212-263-7875
Mailing address:
  • Phone: 212-263-0593
  • Fax: 212-263-7875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number335098
License Number StateNY

VIII. Authorized Official

Name: MRS. VANESSA E GEORGE
Title or Position: FAMILY NURSE PRACTITIONER
Credential: MS
Phone: 646-734-2661