Provider Demographics
NPI:1417972357
Name:SAINT VINCENTS HOSPITAL AND MEDICAL CENTER
Entity Type:Organization
Organization Name:SAINT VINCENTS HOSPITAL AND MEDICAL CENTER
Other - Org Name:RADIOLOGY PROFESSIONAL SERVICES AT ST VINCENT'S HOSPITAL
Other - Org Type:Other Name
Authorized Official - Title/Position:SENIOR VP OF REVENUE CYCLE
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CALDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-356-5944
Mailing Address - Street 1:450 W 33RD ST
Mailing Address - Street 2:12TH FL PBS DEPT
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-2603
Mailing Address - Country:US
Mailing Address - Phone:212-356-4474
Mailing Address - Fax:
Practice Address - Street 1:170 W 12TH ST
Practice Address - Street 2:DEPT. OF RADIOLOGY, LINK-251
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8202
Practice Address - Country:US
Practice Address - Phone:212-604-6275
Practice Address - Fax:212-604-2929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2007-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02386065Medicaid
NY02386065Medicaid
NY0007719033Medicare UPIN