MEDICARE: SAINT VINCENTS HOSPITAL AND MEDICAL CENTER

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	2085R0202X	Diagnostic Radiology Physician

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	:	1417972357
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAINT VINCENTS HOSPITAL AND MEDICAL CENTER

Provider Business Mailing Address
First Line	:	450 W 33RD ST
Second Line	:	12TH FL PBS DEPT
City	:	NEW YORK
State	:	NY
Zip	:	10001-2603
Country	:	US
Telephone Number	:	212-356-4474
Fax Number	:

Provider Business Practice Location Address
First Line	:	170 W 12TH ST
Second Line	:	DEPT. OF RADIOLOGY, LINK-251
City	:	NEW YORK
State	:	NY
Zip	:	10011-8202
Country	:	US
Telephone Number	:	212-604-6275
Fax Number	:	212-604-2929

Authorized Official
Title or Position	:	SENIOR VP OF REVENUE CYCLE
Name	:	MR. MICHAEL CALDER
Credential	:
Telephone Number	:	212-356-5944

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	12/07/2007

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Directions to “SAINT VINCENTS HOSPITAL AND MEDICAL CENTER ” Practice Location

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