Provider Demographics
NPI:1891857025
Name:THE NEW YORK AND PRESBYTERIAN HOSPITAL
Entity Type:Organization
Organization Name:THE NEW YORK AND PRESBYTERIAN HOSPITAL
Other - Org Name:AMBULATORY CARE NETWORK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR VICE PRESIDENT, AMBULATORY C
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACLYN
Authorized Official - Middle Name:A
Authorized Official - Last Name:MUCARIA
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:212-305-7652
Mailing Address - Street 1:622 WEST 168TH STREET
Mailing Address - Street 2:PRESBYTERIAN HOSPITAL BUILDING, ROOM 46
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3720
Mailing Address - Country:US
Mailing Address - Phone:212-305-6008
Mailing Address - Fax:212-342-2709
Practice Address - Street 1:622 WEST 168TH STREET
Practice Address - Street 2:PRESBYTERIAN HOSPITAL BUILDING, ROOM 46
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3720
Practice Address - Country:US
Practice Address - Phone:212-305-6008
Practice Address - Fax:212-342-2709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWAA882Medicare ID - Type Unspecified
NYWAA881Medicare ID - Type Unspecified
NYWAA883Medicare ID - Type Unspecified