Provider Demographics
NPI:1881856201
Name:SAINT VINCENT CATHOLIC MEDICAL CENTERS
Entity Type:Organization
Organization Name:SAINT VINCENT CATHOLIC MEDICAL CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR VP, EXEC DIR BEHAVIORAL HEALTH
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FITZSIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:914-925-5300
Mailing Address - Street 1:144 W 12TH ST
Mailing Address - Street 2:REISS 180
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-8202
Mailing Address - Country:US
Mailing Address - Phone:212-604-8188
Mailing Address - Fax:212-604-3778
Practice Address - Street 1:144 W 12TH ST
Practice Address - Street 2:REISS 180
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8202
Practice Address - Country:US
Practice Address - Phone:212-604-8188
Practice Address - Fax:212-604-3778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-26
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR053792261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health