Provider Demographics
NPI:1912992215
Name:NORTHERN WESTCHESTER HOSPITAL ASSOCIATION
Entity Type:Organization
Organization Name:NORTHERN WESTCHESTER HOSPITAL ASSOCIATION
Other - Org Name:NORTHERN WESTCHESTER HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT & CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:CUSACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-321-6058
Mailing Address - Street 1:400 E MAIN ST
Mailing Address - Street 2:NORTHERN WESTCHESTER HOSPITAL - ADMINISTRATION
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3417
Mailing Address - Country:US
Mailing Address - Phone:914-666-1310
Mailing Address - Fax:914-666-1055
Practice Address - Street 1:400 E MAIN ST
Practice Address - Street 2:NORTHERN WESTCHESTER HOSPITAL
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3417
Practice Address - Country:US
Practice Address - Phone:914-666-1200
Practice Address - Fax:914-666-1055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-13
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6415020273R00000X
NY5920000H282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID0007OtherCARECORE HEALTHNET PIN#
10017300OtherCDPHP PROVIDER ID#
12917OtherAETNA PROVIDER ID #
1000003763OtherAFFINITY HEALTH PLAN ID #
940OtherANTHEM HEALTH PROVIDER ID
MVP HEALTHPLANOther70424
P012006002OtherCORESOURCE STARNET PIN#
NY02997694Medicaid
ID0007OtherHEALTHNET PIN #
NY00274144Medicaid
12917OtherGHI MEDICAID PIN#
CT3025541Medicaid
30729OtherEMPIRE BLUE CROSS PIN#
335869OtherMEDICARE SUB ACUTE
940OtherANTHEM HEALTH PROVIDER ID
12917OtherAETNA PROVIDER ID #
CT3025541Medicaid
ID0007OtherHEALTHNET PIN #
30729OtherEMPIRE BLUE CROSS PIN#
NY330162Medicare Oscar/Certification