Provider Demographics
NPI:1750533378
Name:ST LUKE'S CORNWALL HOSPITAL
Entity type:Organization
Organization Name:ST LUKE'S CORNWALL HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF FINANCE
Authorized Official - Prefix:MRS
Authorized Official - First Name:JILL
Authorized Official - Middle Name:G
Authorized Official - Last Name:BARTON
Authorized Official - Suffix:
Authorized Official - Credentials:8454584023
Authorized Official - Phone:845-458-4040
Mailing Address - Street 1:19 LAUREL AVE FL 3
Mailing Address - Street 2:BUSINESS OFFICE/ ST LUKE'S CORNWALL HOSPITAL
Mailing Address - City:CORNWALL
Mailing Address - State:NY
Mailing Address - Zip Code:12518-1403
Mailing Address - Country:US
Mailing Address - Phone:845-458-4929
Mailing Address - Fax:845-568-2851
Practice Address - Street 1:70 DUBOIS ST
Practice Address - Street 2:HOSPITALIST DEPT, ST LUKE'S CORNWALL HOSPITAL
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-4851
Practice Address - Country:US
Practice Address - Phone:845-568-2827
Practice Address - Fax:845-568-2851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-14
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02812586Medicaid
NYWNW201Medicare Oscar/Certification