=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083905335
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DUKE UNIVERSITY HOSPITAL
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/20/2011
-----------------------------------------------------
Last Update Date | 04/20/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10 HILLTOP RD
-----------------------------------------------------
City | BRONXVILLE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10708-5132
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-980-7462
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10 HILLTOP RD
-----------------------------------------------------
City | BRONXVILLE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10708-5132
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-980-7462
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PROFESSOR
-----------------------------------------------------
Name | SARAH RIVELLI
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 919-668-0869
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 283Q00000X
-----------------------------------------------------
Taxonomy Name | Psychiatric Hospital
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 282N00000X
-----------------------------------------------------
Taxonomy Name | General Acute Care Hospital
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------