Basic Information
Provider Information
NPI: 1659470276
EntityType: 2
ReplacementNPI:  
OrganizationName: NYU LANGONE HOSPITALS
LastName:  
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Mailing Information
Address1: 14 WALL ST FL 10
Address2:  
City: NEW YORK
State: NY
PostalCode: 100052103
CountryCode: US
TelephoneNumber: 8002376977
FaxNumber:  
Practice Location
Address1: 550 1ST AVE
Address2:  
City: NEW YORK
State: NY
PostalCode: 10016
CountryCode: US
TelephoneNumber: 2122631481
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/21/2006
LastUpdateDate: 03/25/2021
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: SMITH
AuthorizedOfficialFirstName: WESLEY
AuthorizedOfficialMiddleName: A.
AuthorizedOfficialTitleorPosition: VP REVENUE CYCLE
AuthorizedOfficialTelephone: 8002376977
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/25/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QX0200X7002053HNYN Ambulatory Health Care FacilitiesClinic/CenterOncology
273R00000X7002053HNYN Hospital UnitsPsychiatric Unit 
282N00000X7002053HNYN HospitalsGeneral Acute Care Hospital 
273Y00000X7002053HNYY Hospital UnitsRehabilitation Unit 

ID Information
IDTypeStateIssuerDescription
00003301NYBLUE CROSSOTHER
0027311605NY MEDICAID
00023101NYBLUE CROSSOTHER


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