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General NPI Number Information
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NPI Number | 1497917983
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Entity Type | Organization
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Legal Business Name | PHELPS MEMORIAL HOSPITAL ASSOCIATION
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Dates
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Enumeration Date | 06/26/2008
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Last Update Date | 07/20/2012
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Provider Practice Location Address
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Address Line | 155 WHITE PLAINS RD 210A
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City | TARRYTOWN
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State | NY
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Zip | 10591-5523
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Country | US
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Telephone | 914-269-1763
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Fax |
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Provider Business Mailing Address
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Address Line | 155 WHITE PLAINS RD 210A
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City | TARRYTOWN
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State | NY
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Zip | 10591-5523
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Country | US
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Telephone | 914-269-1763
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF PROFESSIONAL BILLING
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Name | MR. CHARLES RYKE
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Credential |
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Telephone | 914-269-1763
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 093343-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 106477
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 135197-1
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License Number State | NY
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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 | 155904-1
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License Number State | NY
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