Provider Demographics
NPI:1295029346
Name:ST. LUKE'S ROOSEVELT HOSPITAL CENTER
Entity Type:Organization
Organization Name:ST. LUKE'S ROOSEVELT HOSPITAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:Y
Authorized Official - Last Name:CAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-342-5117
Mailing Address - Street 1:10 AMSTERDAM AVE APT 310
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-7489
Mailing Address - Country:US
Mailing Address - Phone:908-342-5117
Mailing Address - Fax:
Practice Address - Street 1:1111 AMSTERDAM AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-1716
Practice Address - Country:US
Practice Address - Phone:908-342-5117
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital