Provider Demographics
NPI:1194822312
Name:CARITAS HEALTH CARE, INC.
Entity Type:Organization
Organization Name:CARITAS HEALTH CARE, INC.
Other - Org Name:ST JOHNS QUEENS HOSPITAL / MARY IMMACULATE HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:SARLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-830-2712
Mailing Address - Street 1:95-25 QUEENS BOULEVARD
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-4511
Mailing Address - Country:US
Mailing Address - Phone:718-830-2711
Mailing Address - Fax:718-830-3542
Practice Address - Street 1:90-02 QUEENS BOULEVARD
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-4941
Practice Address - Country:US
Practice Address - Phone:718-558-1000
Practice Address - Fax:718-558-1818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
282N00000X
NY7003027H282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00244124Medicaid
NY00243861Medicaid
NY330357060Medicare Oscar/Certification
NY00244124Medicaid
NY00243861Medicaid
NY330357260Medicare Oscar/Certification
NY330357081Medicare Oscar/Certification