Provider Demographics
NPI:1972557379
Name:PUTNAM HOSPITAL CENTER
Entity Type:Organization
Organization Name:PUTNAM HOSPITAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASST VP PATIENT FINANCIAL SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:A
Authorized Official - Last Name:MARCELLUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-838-6361
Mailing Address - Street 1:670 STONELEIGH AVE
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-3997
Mailing Address - Country:US
Mailing Address - Phone:845-279-5711
Mailing Address - Fax:845-838-8062
Practice Address - Street 1:670 STONELEIGH AVE
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-3997
Practice Address - Country:US
Practice Address - Phone:845-279-5711
Practice Address - Fax:845-838-8062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3950000H282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID0021OtherCARE CORE
ID0021OtherHEALTHNET
4581OtherGHI HMO
702915OtherMVP
91193OtherGHI PPO
00208OtherBLUE CROSS
HO3070OtherOXFORD
6450460OtherAETNA
NY00258360Medicaid
10017913OtherCDPHP
NY00258360Medicaid