Provider Demographics
NPI:1922162395
Name:SAINT VINCENT CATHOLIC MEDICAL CENTER
Entity Type:Organization
Organization Name:SAINT VINCENT CATHOLIC MEDICAL CENTER
Other - Org Name:SAINT VINCENT'S COMPREHENSIVE CANCER CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:MS
Authorized Official - First Name:DOLLYANN
Authorized Official - Middle Name:L
Authorized Official - Last Name:YORKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-356-4419
Mailing Address - Street 1:450 W 33RD ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-2603
Mailing Address - Country:US
Mailing Address - Phone:212-356-4419
Mailing Address - Fax:212-356-4439
Practice Address - Street 1:325 W 15TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-5903
Practice Address - Country:US
Practice Address - Phone:888-442-2623
Practice Address - Fax:212-356-4439
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAINT VINCENT CATHOLIC MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-20
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7002037H261QX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0200XAmbulatory Health Care FacilitiesClinic/CenterOncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00243229Medicaid
NY00243229Medicaid
NY330290Medicare Oscar/Certification