Provider Demographics
NPI:1407120181
Name:PHELPS MEMORIAL HOSPITAL HOSPITAL ASSOCIATION
Entity Type:Organization
Organization Name:PHELPS MEMORIAL HOSPITAL HOSPITAL ASSOCIATION
Other - Org Name:PHELPS AT DOBBS FERRY
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF PROFESSIONAL BILLING
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:A
Authorized Official - Last Name:RYKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-366-3134
Mailing Address - Street 1:18 ASHFORD AVE
Mailing Address - Street 2:SUITE MW
Mailing Address - City:DOBBS FERRY
Mailing Address - State:NY
Mailing Address - Zip Code:10522-1823
Mailing Address - Country:US
Mailing Address - Phone:914-478-1384
Mailing Address - Fax:914-478-1378
Practice Address - Street 1:18 ASHFORD AVE
Practice Address - Street 2:SUITE MW
Practice Address - City:DOBBS FERRY
Practice Address - State:NY
Practice Address - Zip Code:10522-1823
Practice Address - Country:US
Practice Address - Phone:914-478-1384
Practice Address - Fax:914-478-1387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-28
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty