Provider Demographics
NPI:1831278951
Name:SAINT JOSEPH'S HOSPITAL LONG TERM HEALTH
Entity type:Organization
Organization Name:SAINT JOSEPH'S HOSPITAL LONG TERM HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT DIRECTOR OF PT FIN SVC
Authorized Official - Prefix:MR
Authorized Official - First Name:DOMINICK
Authorized Official - Middle Name:A
Authorized Official - Last Name:DELIA
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:914-751-0364
Mailing Address - Street 1:127 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-4006
Mailing Address - Country:US
Mailing Address - Phone:914-751-0364
Mailing Address - Fax:914-965-0188
Practice Address - Street 1:127 S BROADWAY
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-4006
Practice Address - Country:US
Practice Address - Phone:914-751-0364
Practice Address - Fax:914-965-0188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5907902L251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00793531Medicaid
NY337194Medicare ID - Type UnspecifiedMEDICARE PROVIDER NO.