Provider Demographics
NPI:1346213469
Name:GOOD SAMARITAN HOSPITAL OF SUFFERN
Entity Type:Organization
Organization Name:GOOD SAMARITAN HOSPITAL OF SUFFERN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EVP
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEAHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-368-5000
Mailing Address - Street 1:255 LAFAYETTE AVE
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-4846
Mailing Address - Country:US
Mailing Address - Phone:845-368-5000
Mailing Address - Fax:845-368-5430
Practice Address - Street 1:255 LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-4846
Practice Address - Country:US
Practice Address - Phone:845-368-5000
Practice Address - Fax:845-368-5430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007297990002Medicaid
NYID0063OtherPHS SMART CHOICE
NY040401000867OtherFIDELIS
NY337015OtherMVP
NY0009822OtherUS HEALTHCARE
PA1007297990003Medicaid
NYID0062OtherHEALTHNET
NY000000004579OtherGHI/HMO
NY000153OtherBLUE CROSS
NJ4155408Medicaid
NY4579OtherWELLCARE
NYH03129OtherOXFORD
NY913OtherANTHEM
NY00273941Medicaid
NY913OtherANTHEM
NY00273941Medicaid