Healthcare Provider Details

I. General information

NPI: 1881982429
Provider Name (Legal Business Name): WHITE PLAINS HOSPITAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2011
Last Update Date: 08/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 WESTCHESTER AVE SUITE 101
WHITE PLAINS NY
10604-2906
US

IV. Provider business mailing address

222 WESTCHESTER AVE SUITE 101
WHITE PLAINS NY
10604-2906
US

V. Phone/Fax

Practice location:
  • Phone: 914-946-1010
  • Fax: 914-946-1025
Mailing address:
  • Phone: 914-946-1010
  • Fax: 914-946-1025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name: EDWARD LEONARD
Title or Position: EXECUTIVE VP/COO
Credential:
Phone: 914-681-1210