Provider Demographics
NPI:1881926426
Name:ST.LUKES-ROOSEVELT HOSPITAL
Entity type:Organization
Organization Name:ST.LUKES-ROOSEVELT HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MAISOUN
Authorized Official - Middle Name:
Authorized Official - Last Name:SIOUFI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:212-636-3603
Mailing Address - Street 1:1000 10TH AVE # 2T
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1147
Mailing Address - Country:US
Mailing Address - Phone:212-636-3600
Mailing Address - Fax:212-636-3601
Practice Address - Street 1:1000 10TH AVE # 2T
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1147
Practice Address - Country:US
Practice Address - Phone:212-636-3600
Practice Address - Fax:212-636-3601
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CONTIUNUUM HEALTH PARTNERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-02-08
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039738282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY039738OtherLICENSE#