MEDICARE: MORGAN STANLEY CHILDREN'S HOSPITAL

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	282NC2000X	Children's Hospital	F382290	NY
2	282NC2000X	Children's Hospital	237802	NY
3	282NC2000X	Children's Hospital	272913	NY
4	282NC2000X	Children's Hospital	208263	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326464355
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MORGAN STANLEY CHILDREN'S HOSPITAL

Provider Business Mailing Address
First Line	:	3959 BROADWAY, CHN - 1102
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10032-0000
Country	:	US
Telephone Number	:	212-342-0416
Fax Number	:	212-305-9918

Provider Business Practice Location Address
First Line	:	3959 BROADWAY, CHN - 1102
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10032-0000
Country	:	US
Telephone Number	:	212-342-0416
Fax Number	:	212-305-9918

Authorized Official
Title or Position	:	SUPERVISOR
Name	:	DANIELLE ROBERTO
Credential	:
Telephone Number	:	212-342-0416

Provider Enumeration Date	:	03/14/2014
Last Update Date	:	03/14/2014

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Directions to “MORGAN STANLEY CHILDREN'S HOSPITAL ” Practice Location

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