Provider Demographics
NPI:1891900775
Name:ST. LUKES ROOSEVELT HOSPITAL CENTER
Entity Type:Organization
Organization Name:ST. LUKES ROOSEVELT HOSPITAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE MIDWIFE
Authorized Official - Prefix:MS
Authorized Official - First Name:LUCY
Authorized Official - Middle Name:
Authorized Official - Last Name:EISENSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:CNM
Authorized Official - Phone:212-523-4461
Mailing Address - Street 1:122 WELLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:SHORT HILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07078-2560
Mailing Address - Country:US
Mailing Address - Phone:718-757-0083
Mailing Address - Fax:
Practice Address - Street 1:1111 AMSTERDAM AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-1716
Practice Address - Country:US
Practice Address - Phone:212-523-4461
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-13
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF000577-1282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital