MEDICARE: ST. VINCENT'S SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	084708-1	NY

General Provider Information

NPI Number	:	1225302508
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ST. VINCENT'S SERVICES

Provider Business Mailing Address
First Line	:	7 PARK AVE
Second Line	:	APT. 145
City	:	NEW YORK
State	:	NY
Zip	:	10016-4349
Country	:	US
Telephone Number	:	212-447-5534
Fax Number	:

Provider Business Practice Location Address
First Line	:	7 PARK AVE
Second Line	:	APT 145
City	:	NEW YORK
State	:	NY
Zip	:	10016-4349
Country	:	US
Telephone Number	:	212-447-5534
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. ROBERT A FREEMAN
Credential	:	M.D.
Telephone Number	:	718-422-2287

Provider Enumeration Date	:	03/03/2012
Last Update Date	:	03/03/2012

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