Provider Demographics
NPI:1326464355
Name:MORGAN STANLEY CHILDREN'S HOSPITAL
Entity Type:Organization
Organization Name:MORGAN STANLEY CHILDREN'S HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-342-0416
Mailing Address - Street 1:3959 BROADWAY, CHN - 1102
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-0000
Mailing Address - Country:US
Mailing Address - Phone:212-342-0416
Mailing Address - Fax:212-305-9918
Practice Address - Street 1:3959 BROADWAY, CHN - 1102
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-0000
Practice Address - Country:US
Practice Address - Phone:212-342-0416
Practice Address - Fax:212-305-9918
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW YORK PRESBYTERIAN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-03-14
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY208263282NC2000X
NYF382290282NC2000X
NY237802282NC2000X
NY272913282NC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02754901Medicaid
NY02754901Medicaid