Provider Demographics
NPI:1225357452
Name:ST JOSEPH'S HOSPITAL HEALTH CENTER
Entity Type:Organization
Organization Name:ST JOSEPH'S HOSPITAL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:H
Authorized Official - Last Name:RUSCITTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-448-5880
Mailing Address - Street 1:301 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13203-1807
Mailing Address - Country:US
Mailing Address - Phone:315-448-5375
Mailing Address - Fax:315-448-6506
Practice Address - Street 1:301 PROSPECT AVE
Practice Address - Street 2:INPATIENT AKU
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13203-1807
Practice Address - Country:US
Practice Address - Phone:315-448-5343
Practice Address - Fax:315-448-6571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-27
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3301003H282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
330140Medicare PIN