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General NPI Number Information
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NPI Number | 1912061706
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Entity Type | Organization
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Legal Business Name | GOOD SAMARITAN HOSPITAL
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 255 LAFAYETTE AVE
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City | SUFFERN
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State | NY
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Zip | 10901-4812
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Country | US
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Telephone | 845-368-5983
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Fax | 845-368-5989
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Provider Business Mailing Address
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Address Line | 41 WILDERNESS DR
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City | STONY POINT
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State | NY
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Zip | 10980-3447
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Country | US
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Telephone | 845-368-5983
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Fax | 845-368-5989
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Authorized Official
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Title or Position | VPMA
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Name | DR. WILLIAM CORS
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Credential | MD
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Telephone | 845-368-5540
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 222260
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License Number State | NY
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