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General NPI Number Information
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NPI Number | 1033361340
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Entity Type | Organization
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Legal Business Name | ST LUKE'S CORNWALL HOSPITAL
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Dates
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Enumeration Date | 10/17/2008
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Last Update Date | 09/28/2011
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Provider Practice Location Address
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Address Line | 21 LAUREL AVE STE 240 FACULTY GROUP PRACTICE ST LUKE'S CORNWALL HOSPITAL
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City | CORNWALL
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State | NY
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Zip | 12518-1476
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Country | US
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Telephone | 845-458-4876
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Fax | 845-458-4560
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Provider Business Mailing Address
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Address Line | 21 LAUREL AVE STE 240 FACULTY GROUP PRACTICE ST LUKE'S CORNWALL HOSPITAL
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City | CORNWALL
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State | NY
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Zip | 12518-1476
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Country | US
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Telephone | 845-458-4876
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Fax | 845-458-4560
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Authorized Official
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Title or Position | VICE PRESIDENT OF FINANCE
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Name | MRS. JILL G BARTON
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Credential |
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Telephone | 845-458-4023
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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