Basic Information
| Provider Information | |||||||||
| NPI: | 1063645398 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ST. VINCENT'S CATHOLIC MEDICAL CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 101 W 15TH ST APT 2GS | ||||||||
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| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100116584 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 153 W 11TH ST | ||||||||
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| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100118305 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2126047000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/03/2009 | ||||||||
| LastUpdateDate: | 09/03/2009 | ||||||||
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| AuthorizedOfficialLastName: | SMITH | ||||||||
| AuthorizedOfficialFirstName: | MRAGARET | ||||||||
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| AuthorizedOfficialTitleorPosition: | INTERNAL MEDICINE PROGRAM DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 2126047000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 00243229 | NY | Y | Hospitals | General Acute Care Hospital |
No ID Information.