Provider Demographics
NPI:1851644900
Name:PHELPS MEMORIA HOSPITAL CENTER
Entity Type:Organization
Organization Name:PHELPS MEMORIA HOSPITAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANJUM
Authorized Official - Middle Name:
Authorized Official - Last Name:LONE
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L CHT
Authorized Official - Phone:914-366-3717
Mailing Address - Street 1:59 MYSTIC DR
Mailing Address - Street 2:
Mailing Address - City:OSSINING
Mailing Address - State:NY
Mailing Address - Zip Code:10562-1965
Mailing Address - Country:US
Mailing Address - Phone:914-762-1797
Mailing Address - Fax:
Practice Address - Street 1:701 N BROADWAY
Practice Address - Street 2:
Practice Address - City:SLEEPY HOLLOW
Practice Address - State:NY
Practice Address - Zip Code:10591-1020
Practice Address - Country:US
Practice Address - Phone:914-366-3717
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-25
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014401-1282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital