Provider Demographics
NPI:1245583921
Name:PHELPS MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:PHELPS MEMORIAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SLP
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:DINU
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:914-366-3011
Mailing Address - Street 1:220 CHESTNUT ST
Mailing Address - Street 2:APT 3M
Mailing Address - City:PORT CHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:10573-3149
Mailing Address - Country:US
Mailing Address - Phone:914-224-6891
Mailing Address - Fax:
Practice Address - Street 1:777 N BROADWAY
Practice Address - Street 2:SUITE 303
Practice Address - City:SLEEPY HOLLOW
Practice Address - State:NY
Practice Address - Zip Code:10591-1000
Practice Address - Country:US
Practice Address - Phone:914-366-3011
Practice Address - Fax:914-366-1359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-18
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital