Healthcare Provider Details

I. General information

NPI: 1598884017
Provider Name (Legal Business Name): NYU MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

545 1ST AVE # C-120
NEW YORK NY
10016-6401
US

IV. Provider business mailing address

66 E 93RD ST APT 1F
NEW YORK NY
10128-1345
US

V. Phone/Fax

Practice location:
  • Phone: 212-263-6600
  • Fax:
Mailing address:
  • Phone: 917-691-2149
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number214128-1
License Number StateNY

VIII. Authorized Official

Name: DR. JESSICA FOLITN
Title or Position: DIRECTOR PEDIATRIC EMERGENCY
Credential: MD
Phone: 212-263-6600