Provider Demographics
NPI:1235137431
Name:OUR LADY OF MERCY MEDICAL CENTER
Entity Type:Organization
Organization Name:OUR LADY OF MERCY MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR PROVIDER SERVICES
Authorized Official - Prefix:MISS
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:DOWLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-377-4668
Mailing Address - Street 1:100 CORPORATE DR
Mailing Address - Street 2:CMO
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-6807
Mailing Address - Country:US
Mailing Address - Phone:914-378-6163
Mailing Address - Fax:914-709-0386
Practice Address - Street 1:600 E 233RD ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466-2604
Practice Address - Country:US
Practice Address - Phone:718-920-9000
Practice Address - Fax:914-709-0386
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-12
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY040403003073OtherFIDELIS PROVIDER NUMBER
NY000021OtherBLUE CROSS PROVIDER NUMBER
NY00243563Medicaid
NY000821OtherBLUE CROSS PROVIDER NUMBER
NYHO3109OtherOXFORD PROVIDER NUMBER
NYHO3109AOtherOXFORD PROVIDER NUMBER
NY332316Medicare Oscar/Certification
NY330072Medicare Oscar/Certification
NY33S072Medicare Oscar/Certification