Provider Demographics
NPI:1093015638
Name:ST. LUKES ROOSEVELT HOSPITAL - INN
Entity Type:Organization
Organization Name:ST. LUKES ROOSEVELT HOSPITAL - INN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEJANDRO
Authorized Official - Middle Name:
Authorized Official - Last Name:BERENSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:212-636-3400
Mailing Address - Street 1:515 W 59TH ST APT 4A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1034
Mailing Address - Country:US
Mailing Address - Phone:917-402-2471
Mailing Address - Fax:
Practice Address - Street 1:515 W, 59TH ST.,
Practice Address - Street 2:APT 4A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1034
Practice Address - Country:US
Practice Address - Phone:917-402-2471
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-29
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP77949282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital