Provider Demographics
NPI:1851340608
Name:NEW YORK WESTCHESTER SQ MED CTR
Entity Type:Organization
Organization Name:NEW YORK WESTCHESTER SQ MED CTR
Other - Org Name:WESTCHESTER SQUARE MEDICAL CENTER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KOPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-430-7350
Mailing Address - Street 1:2475 SAINT RAYMONDS AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-3124
Mailing Address - Country:US
Mailing Address - Phone:718-430-7359
Mailing Address - Fax:718-430-4359
Practice Address - Street 1:2475 SAINT RAYMONDS AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-3124
Practice Address - Country:US
Practice Address - Phone:718-430-7359
Practice Address - Fax:718-430-4359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-09
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7000025H282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00273092Medicaid
NY330316Medicare Oscar/Certification