=====================================================
General NPI Number Information
=====================================================
NPI Number | 1710331426
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NEW YORK PRESBYTERIAN HOSPITAL
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/19/2016
-----------------------------------------------------
Last Update Date | 04/21/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 161 FORT WASHINGTON AVE HIP-12
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10032-3729
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-938-1276
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 161 FORT WASHINGTON AVE HIP-12
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10032-3729
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-938-1276
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DERMATOLOGY PROGRAM DIRECTOR
-----------------------------------------------------
Name | CHERYL HUTT
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 212-305-5317
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207N00000X
-----------------------------------------------------
Taxonomy Name | Dermatology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------