Provider Demographics
NPI:1013418698
Name:THE ST. LUKES ROOSEVELT HOSPITAL CENTER
Entity Type:Organization
Organization Name:THE ST. LUKES ROOSEVELT HOSPITAL CENTER
Other - Org Name:MOUNT SINAI HEALTH HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAKIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-256-3001
Mailing Address - Street 1:150 E 42ND ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-5612
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:320 E 94TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-5604
Practice Address - Country:US
Practice Address - Phone:212-241-3257
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST LUKE ROOSEVELT HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-02-28
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management