Provider Demographics
NPI:1053684308
Name:WHITE PLAINS HOSPITAL MEDICAL CENTER
Entity Type:Organization
Organization Name:WHITE PLAINS HOSPITAL MEDICAL CENTER
Other - Org Name:VASCULAR AND THORACIC ASSOCIATES
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO/COO
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:LEONARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-681-1211
Mailing Address - Street 1:41 E POST RD
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-4607
Mailing Address - Country:US
Mailing Address - Phone:914-681-1210
Mailing Address - Fax:
Practice Address - Street 1:4 LYON PL
Practice Address - Street 2:SUITE LL2
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-5415
Practice Address - Country:US
Practice Address - Phone:914-681-2742
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-17
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1922180190OtherNPI
NY97F79LMedicare PIN