Provider Demographics
NPI:1972872505
Name:ST JOSEPH'S HOSPITAL HEALTH CENTER
Entity Type:Organization
Organization Name:ST JOSEPH'S HOSPITAL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLINICAL AFFILIATE SERV
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:ESPOSITO
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:315-448-2876
Mailing Address - Street 1:647 WATERFRONT DR E
Mailing Address - Street 2:8305
Mailing Address - City:HOMESTEAD
Mailing Address - State:PA
Mailing Address - Zip Code:15120-5041
Mailing Address - Country:US
Mailing Address - Phone:917-455-8923
Mailing Address - Fax:
Practice Address - Street 1:301 PROSPECT AVENUE
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13203-1898
Practice Address - Country:US
Practice Address - Phone:315-448-5111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-28
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY23015390282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital