Provider Demographics
NPI:1205944329
Name:HOSPITALIST MEDICINE PHYSICIANS OF NEW YORK, PLLC
Entity type:Organization
Organization Name:HOSPITALIST MEDICINE PHYSICIANS OF NEW YORK, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:FALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-682-6040
Mailing Address - Street 1:120 BRENTWOOD COMMONS WAY STE 510
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-2028
Mailing Address - Country:US
Mailing Address - Phone:615-377-1674
Mailing Address - Fax:
Practice Address - Street 1:2475 SAINT RAYMONDS AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-3124
Practice Address - Country:US
Practice Address - Phone:718-920-8543
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA100227034OtherMEDICARE
NY02829803Medicaid