Provider Demographics
NPI:1205851821
Name:PHELPS MEMORIAL HOSPITAL ASSOCIATION
Entity Type:Organization
Organization Name:PHELPS MEMORIAL HOSPITAL ASSOCIATION
Other - Org Name:PHELPS MEMORIAL HOSPITAL EMERGENCY PHYSICIANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER, PATIENT ACCOUNTS
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:RYKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-366-3134
Mailing Address - Street 1:PO BOX 13700-1365
Mailing Address - Street 2:C/O PHELPS MEMORIAL HOSPITAL EMERGENCY PHYSICIANS
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19191-1365
Mailing Address - Country:US
Mailing Address - Phone:800-666-2455
Mailing Address - Fax:610-660-9384
Practice Address - Street 1:701 NORTH BROADWAY
Practice Address - Street 2:PHELPS MEMORIAL HOSPITAL
Practice Address - City:SLEEPY HOLLOW
Practice Address - State:NY
Practice Address - Zip Code:10591
Practice Address - Country:US
Practice Address - Phone:914-366-1554
Practice Address - Fax:610-660-9384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2009-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW74181Medicare ID - Type Unspecified