1245583921 NPI number — PHELPS MEMORIAL HOSPITAL

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 1245583921 NPI number — PHELPS MEMORIAL HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PHELPS MEMORIAL HOSPITAL
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:
1245583921
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/18/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
220 CHESTNUT ST
Provider Second Line Business Mailing Address:
APT 3M
Provider Business Mailing Address City Name:
PORT CHESTER
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10573-3149
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-224-6891
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
777 N BROADWAY
Provider Second Line Business Practice Location Address:
SUITE 303
Provider Business Practice Location Address City Name:
SLEEPY HOLLOW
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10591-1000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-366-3011
Provider Business Practice Location Address Fax Number:
914-366-1359
Provider Enumeration Date:
10/18/2012

Additional Information

Authorized Official

Authorized Official Last Name:
DINU
Authorized Official First Name:
PAULA
Authorized Official Middle Name:
Authorized Official Title or Position:
SLP
Authorized Official Telephone Number:
914-366-3011

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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