1699798934 NPI number — BETH ISRAEL MEDICAL CENTER

Table of content: (NPI 1699798934)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699798934 NPI number — BETH ISRAEL MEDICAL CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BETH ISRAEL MEDICAL CENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
BETH ISRAEL HOSPITAL CLINIC LAB
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699798934
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/29/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1900 HEMPSTEAD TURNPIKE
Provider Second Line Business Mailing Address:
SUITE 500
Provider Business Mailing Address City Name:
EAST MEADOW
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11554-1724
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-542-1090
Provider Business Mailing Address Fax Number:
516-794-8165

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10 NATHAN D PERLMAN PLACE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SUITE 12S34
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10003-3851
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-420-2124
Provider Business Practice Location Address Fax Number:
212-420-3449
Provider Enumeration Date:
07/26/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WENIG
Authorized Official First Name:
BRUCE
Authorized Official Middle Name:
Authorized Official Title or Position:
CHAIRMAN
Authorized Official Telephone Number:
212-420-2124

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 02985073 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 33D0667624 . This is a "CLIA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".