Provider Demographics
NPI:1508398868
Name:WYKOFF HEIGHTS MEDICAL CENTER
Entity Type:Organization
Organization Name:WYKOFF HEIGHTS MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:VUTRANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-963-7152
Mailing Address - Street 1:240 WASHINGTON BLVD
Mailing Address - Street 2:3B
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-4123
Mailing Address - Country:US
Mailing Address - Phone:469-231-4048
Mailing Address - Fax:
Practice Address - Street 1:240 WASHINGTON BLVD
Practice Address - Street 2:3B
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-4123
Practice Address - Country:US
Practice Address - Phone:469-231-4048
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-28
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty