Healthcare Provider Details

I. General information

NPI: 1609174937
Provider Name (Legal Business Name): WHITE PLAINS HOSPITAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2011
Last Update Date: 03/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 MAPLE AVE SUITE 502
WHITE PLAINS NY
10601-4710
US

IV. Provider business mailing address

170 MAPLE AVE SUITE 502
WHITE PLAINS NY
10601-4710
US

V. Phone/Fax

Practice location:
  • Phone: 914-948-1000
  • Fax:
Mailing address:
  • Phone: 914-948-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RB0002X
TaxonomyObesity Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN B SCIURBA
Title or Position: CFO/VP FINANCE
Credential:
Phone: 914-681-1200