Provider Demographics
NPI:1629036751
Name:NEW YORK DOWNTOWN HOSPITAL FPP
Entity Type:Organization
Organization Name:NEW YORK DOWNTOWN HOSPITAL FPP
Other - Org Name:NYDH EMERGENCY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHAIR ED
Authorized Official - Prefix:
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:
Authorized Official - Last Name:DAJER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-312-5068
Mailing Address - Street 1:PO BOX 10309
Mailing Address - Street 2:NYDH EMERGENCY SERVICES
Mailing Address - City:UNIONDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11555-0309
Mailing Address - Country:US
Mailing Address - Phone:190-480-5115
Mailing Address - Fax:
Practice Address - Street 1:170 WILLIAM ST
Practice Address - Street 2:NEW YORK DOWNTOWN HOSPITAL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-2612
Practice Address - Country:US
Practice Address - Phone:212-312-5068
Practice Address - Fax:212-312-5985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-01
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW6L441Medicare ID - Type Unspecified