Provider Demographics
NPI:1275624199
Name:BETH ISRAEL MEDICAL CENTER
Entity Type:Organization
Organization Name:BETH ISRAEL MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SABRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:LITTLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-420-4714
Mailing Address - Street 1:10 NATHAN D PERLMAN PL
Mailing Address - Street 2:2 BERNSTEIN PAVILION - ATTN: SABRINA LITTLE
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-3851
Mailing Address - Country:US
Mailing Address - Phone:212-420-4714
Mailing Address - Fax:212-420-4397
Practice Address - Street 1:10 NATHAN D PERLMAN PL
Practice Address - Street 2:2 BERNSTEIN PAVILION - ATTN: SABRINA LITTLE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3851
Practice Address - Country:US
Practice Address - Phone:212-420-4714
Practice Address - Fax:212-420-4397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWANA21Medicare PIN