MEDICARE: BETH ISRAEL 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	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1659511798
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BETH ISRAEL MEDICAL CENTER

Provider Business Mailing Address
First Line	:	9 NATHAN D PERLMAN PL
Second Line	:	10 BERNSTEIN PAVILION
City	:	NEW YORK
State	:	NY
Zip	:	10003-3801
Country	:	US
Telephone Number	:	212-420-4714
Fax Number	:	212-420-3936

Provider Business Practice Location Address
First Line	:	9 NATHAN D PERLMAN PL
Second Line	:	10 BERNSTEIN PAVILION
City	:	NEW YORK
State	:	NY
Zip	:	10003-3801
Country	:	US
Telephone Number	:	212-420-4714
Fax Number	:	212-420-3936

Authorized Official
Title or Position	:	BILLING SUPERVISOR
Name	:	MRS. SABRINA LITTLE
Credential	:
Telephone Number	:	212-420-4714

Provider Enumeration Date	:	03/03/2009
Last Update Date	:	09/10/2009

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Directions to “BETH ISRAEL MEDICAL CENTER ” Practice Location

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