Provider Demographics
NPI:1497280903
Name:NEW YORK-PRESBYTERIAN/QUEENS
Entity Type:Organization
Organization Name:NEW YORK-PRESBYTERIAN/QUEENS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENTI PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:PRUDENTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-680-8138
Mailing Address - Street 1:514 WASHINGTON ST
Mailing Address - Street 2:1
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-4906
Mailing Address - Country:US
Mailing Address - Phone:631-680-8138
Mailing Address - Fax:
Practice Address - Street 1:514 WASHINGTON ST
Practice Address - Street 2:1
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-4906
Practice Address - Country:US
Practice Address - Phone:631-680-8138
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-23
Last Update Date:2017-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital