Basic Information
| Provider Information | |||||||||
| NPI: | 1598864118 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NYU HOSPITALS CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 PARK AVE | ||||||||
| Address2: | 17TH FLOOR | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100165802 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2122631481 | ||||||||
| FaxNumber: | 2124043608 | ||||||||
| Practice Location | |||||||||
| Address1: | 550 1ST AVE | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100166402 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2122631481 | ||||||||
| FaxNumber: | 2124043608 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/21/2006 | ||||||||
| LastUpdateDate: | 03/26/2021 | ||||||||
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| AuthorizedOfficialLastName: | SMITH | ||||||||
| AuthorizedOfficialFirstName: | WESLEY | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | VP REVENUE CYCLE | ||||||||
| AuthorizedOfficialTelephone: | 2122631481 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| NPICertificationDate: | 03/26/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QX0200X | 7002053H | NY | N | Ambulatory Health Care Facilities | Clinic/Center | Oncology | 273R00000X | 7002053H | NY | N | Hospital Units | Psychiatric Unit | 273Y00000X | 7002053H | NY | N | Hospital Units | Rehabilitation Unit | 282N00000X | 7002053H | NY | Y | Hospitals | General Acute Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | 000033 | 01 | NY | BLUE CROSS | OTHER | 00273116 | 05 | NY | MEDICAID |