Basic Information
| Provider Information | |||||||||
| NPI: | 1174068761 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | KEYSTONE HOSPITALIST SERVICES OF NEW YORK P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1201 W SWANN AVE | ||||||||
| Address2: | |||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336062639 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9017953600 | ||||||||
| FaxNumber: | 9017956060 | ||||||||
| Practice Location | |||||||||
| Address1: | 515 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | OLEAN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 147601513 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7163732600 | ||||||||
| FaxNumber: | 9017956060 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/05/2017 | ||||||||
| LastUpdateDate: | 01/06/2022 | ||||||||
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| AuthorizedOfficialLastName: | GLANTZ | ||||||||
| AuthorizedOfficialFirstName: | SANFORD | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9017953600 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 01/06/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.