Provider Demographics
NPI:1740681568
Name:HUNTINGTON HOSPITAL ASSOCIATION
Entity type:Organization
Organization Name:HUNTINGTON HOSPITAL ASSOCIATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-425-4262
Mailing Address - Street 1:PO BOX 415655
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-5661
Mailing Address - Country:US
Mailing Address - Phone:631-547-6392
Mailing Address - Fax:631-351-7861
Practice Address - Street 1:270 PARK AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-2787
Practice Address - Country:US
Practice Address - Phone:631-547-6392
Practice Address - Fax:631-351-7861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-11
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty