1205851821 NPI number — PHELPS MEMORIAL HOSPITAL ASSOCIATION

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205851821 NPI number — PHELPS MEMORIAL HOSPITAL ASSOCIATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PHELPS MEMORIAL HOSPITAL ASSOCIATION
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:
PHELPS MEMORIAL HOSPITAL EMERGENCY PHYSICIANS
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:
1205851821
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/24/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 13700-1365
Provider Second Line Business Mailing Address:
C/O PHELPS MEMORIAL HOSPITAL EMERGENCY PHYSICIANS
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19191-1365
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-666-2455
Provider Business Mailing Address Fax Number:
610-660-9384

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
701 NORTH BROADWAY
Provider Second Line Business Practice Location Address:
PHELPS MEMORIAL HOSPITAL
Provider Business Practice Location Address City Name:
SLEEPY HOLLOW
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10591
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-366-1554
Provider Business Practice Location Address Fax Number:
610-660-9384
Provider Enumeration Date:
07/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
RYKE
Authorized Official First Name:
CHARLES
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGER, PATIENT ACCOUNTS
Authorized Official Telephone Number:
914-366-3134

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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