Provider Demographics
NPI:1497741763
Name:ST CATHERINE OF SIENA MEDICAL CENTER
Entity Type:Organization
Organization Name:ST CATHERINE OF SIENA MEDICAL CENTER
Other - Org Name:ST CATHERINE OF SIENA NURSING HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:HAIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-587-1600
Mailing Address - Street 1:52 ROUTE 25A
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787
Mailing Address - Country:US
Mailing Address - Phone:631-862-3951
Mailing Address - Fax:631-862-3906
Practice Address - Street 1:52 ROUTE 25A
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-1346
Practice Address - Country:US
Practice Address - Phone:631-862-3900
Practice Address - Fax:631-862-3983
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST CATHERINE OF SIENA MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-09-22
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5157312N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02060153Medicaid
NY02060153Medicaid