Basic Information
| Provider Information | |||||||||
| NPI: | 1851587000 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SURGICAL SERVICES OF ST VINCENTS PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 450 W 33RD ST | ||||||||
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| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100012603 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2123564978 | ||||||||
| FaxNumber: | 2123564608 | ||||||||
| Practice Location | |||||||||
| Address1: | 170 W 12TH ST | ||||||||
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| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100118202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2126047000 | ||||||||
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| ProviderEnumerationDate: | 09/21/2007 | ||||||||
| LastUpdateDate: | 09/21/2007 | ||||||||
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| AuthorizedOfficialLastName: | CALDER | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
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| AuthorizedOfficialTitleorPosition: | SR VP OF REVENUE CYCLE | ||||||||
| AuthorizedOfficialTelephone: | 2123565944 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.