Healthcare Provider Details

I. General information

NPI: 1750533378
Provider Name (Legal Business Name): ST LUKE'S CORNWALL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2008
Last Update Date: 09/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 DUBOIS ST HOSPITALIST DEPT, ST LUKE'S CORNWALL HOSPITAL
NEWBURGH NY
12550-4851
US

IV. Provider business mailing address

19 LAUREL AVE FL 3 BUSINESS OFFICE/ ST LUKE'S CORNWALL HOSPITAL
CORNWALL NY
12518-1403
US

V. Phone/Fax

Practice location:
  • Phone: 845-568-2827
  • Fax: 845-568-2851
Mailing address:
  • Phone: 845-458-4929
  • Fax: 845-568-2851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. JILL G BARTON
Title or Position: VICE PRESIDENT OF FINANCE
Credential: 8454584023
Phone: 845-458-4040