Provider Demographics
NPI:1003923434
Name:ST. LUKE'S CORNWALL HOSPITAL
Entity Type:Organization
Organization Name:ST. LUKE'S CORNWALL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF REVENUE CYCLE
Authorized Official - Prefix:MRS
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-568-2770
Mailing Address - Street 1:70 DUBOIS ST
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-4851
Mailing Address - Country:US
Mailing Address - Phone:845-561-4400
Mailing Address - Fax:
Practice Address - Street 1:70 DUBOIS ST
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-4851
Practice Address - Country:US
Practice Address - Phone:845-561-4400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2016-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3522000H282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH04201OtherOXFORD HEALTH PLAN
NY10014302OtherCDPHP
NY04539OtherBENEFIT PLAN ADMIN
104575OtherWELLCARE
43910OtherGHI
NY60966OtherLOCAL 445
NY60966OtherUS HEALTHCARE
NY701715OtherMVP HEALTH PLAN
NYIC8857OtherHEALTHNET
NY00156OtherBLUE CROSS
NY273863Medicaid
NYH04201OtherOXFORD HEALTH PLAN