Provider Demographics
NPI:1184941742
Name:NEW YORK PRESBYTERIAN HOSPITAL
Entity type:Organization
Organization Name:NEW YORK PRESBYTERIAN HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:PROF
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:MARBOE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-305-8063
Mailing Address - Street 1:28 ADAMS ST UNIT 204
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01604-1685
Mailing Address - Country:US
Mailing Address - Phone:774-823-9187
Mailing Address - Fax:
Practice Address - Street 1:28 ADAMS ST UNIT 204
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01604-1685
Practice Address - Country:US
Practice Address - Phone:774-823-9187
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-22
Last Update Date:2010-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital