Basic Information
| Provider Information | |||||||||
| NPI: | 1306163381 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ST. VINCENT'S HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 136 HICKS ST | ||||||||
| Address2: | APT 2C | ||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112012366 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 136 HICKS ST | ||||||||
| Address2: | APT 2C | ||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112012366 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2126047000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/29/2010 | ||||||||
| LastUpdateDate: | 04/29/2010 | ||||||||
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| AuthorizedOfficialLastName: | FARUZZO | ||||||||
| AuthorizedOfficialFirstName: | ABBEY | ||||||||
| AuthorizedOfficialMiddleName: | LYNN | ||||||||
| AuthorizedOfficialTitleorPosition: | PGY-2 PSYCHIATRY | ||||||||
| AuthorizedOfficialTelephone: | 6314634634 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | D.O. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 283Q00000X | Y | Hospitals | Psychiatric Hospital |
No ID Information.