1215050307 NPI number — NEW YORK PRESBYTERIAN MEDICAL CENTER

Table of content: (NPI 1215050307)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215050307 NPI number — NEW YORK PRESBYTERIAN MEDICAL CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW YORK PRESBYTERIAN 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:
Provider Other Organization Name Type Code:
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:
1215050307
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1066 FULTON ST
Provider Second Line Business Mailing Address:
PH
Provider Business Mailing Address City Name:
BROOKLYN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11238-2600
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
917-903-7274
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
180 FORT WASHINGTON AVE
Provider Second Line Business Practice Location Address:
HP6 CLINIC
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10032-3735
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-305-3174
Provider Business Practice Location Address Fax Number:
212-305-7692
Provider Enumeration Date:
04/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SAWO
Authorized Official First Name:
DOROTHY
Authorized Official Middle Name:
JARTU
Authorized Official Title or Position:
HIV PRIMARY CARE
Authorized Official Telephone Number:
212-305-3174

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  F331008 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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