Provider Demographics
NPI:1659511798
Name:BETH ISRAEL MEDICAL CENTER
Entity Type:Organization
Organization Name:BETH ISRAEL MEDICAL CENTER
Other - Org Name:BIMC NEUROBEHAVIORAL ALZHEIMER DISEASE ASSOC.
Other - Org Type:Other Name
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SABRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:LITTLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-420-4714
Mailing Address - Street 1:9 NATHAN D PERLMAN PL
Mailing Address - Street 2:10 BERNSTEIN PAVILION
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-3801
Mailing Address - Country:US
Mailing Address - Phone:212-420-4714
Mailing Address - Fax:212-420-3936
Practice Address - Street 1:9 NATHAN D PERLMAN PL
Practice Address - Street 2:10 BERNSTEIN PAVILION
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3801
Practice Address - Country:US
Practice Address - Phone:212-420-4714
Practice Address - Fax:212-420-3936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-03
Last Update Date:2009-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYY15661Medicare UPIN
NYWER501Medicare PIN