Provider Demographics
NPI:1932400140
Name:ST.VINCENT' HOSPITAL WESTCHESTER PSYCH
Entity Type:Organization
Organization Name:ST.VINCENT' HOSPITAL WESTCHESTER PSYCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V.P. FINANCE BH
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:PAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-925-5333
Mailing Address - Street 1:275 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10528-1524
Mailing Address - Country:US
Mailing Address - Phone:914-925-5333
Mailing Address - Fax:914-925-5136
Practice Address - Street 1:275 NORTH ST
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:NY
Practice Address - Zip Code:10528-1524
Practice Address - Country:US
Practice Address - Phone:914-925-5333
Practice Address - Fax:914-925-5136
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAINT JOSEPH'S HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-11-04
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103T00000X, 103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW75651Medicare Oscar/Certification