Basic Information
| Provider Information | |||||||||
| NPI: | 1316218100 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NORTHERN WESTCHESTER HOSPITAL ASSOCIATION | ||||||||
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| OtherOrganizationName: | NUTRITIONAL SERVICES DEPT. | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 400 E MAIN ST | ||||||||
| Address2: | MEDICAL AFFAIRS OFFICE | ||||||||
| City: | MOUNT KISCO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105493417 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9142428318 | ||||||||
| FaxNumber: | 9146661965 | ||||||||
| Practice Location | |||||||||
| Address1: | 400 E MAIN ST | ||||||||
| Address2: | MEDICAL AFFAIRS OFFICE | ||||||||
| City: | MOUNT KISCO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105493417 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9142428318 | ||||||||
| FaxNumber: | 9146661965 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/25/2012 | ||||||||
| LastUpdateDate: | 01/26/2012 | ||||||||
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| AuthorizedOfficialLastName: | PARTENZA | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 9146661310 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | NORTHERN WESTCHESTER HOSPITAL ASSOCIATION | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133NN1002X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Dietary & Nutritional Service Providers | Nutritionist | Nutrition, Education | 133V00000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.