Basic Information
| Provider Information | |||||||||
| NPI: | 1558621698 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MANHATTAN VETERANS AFFAIRS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 91 CENTRAL PARK W | ||||||||
| Address2: | APT. 3F | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100234609 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2126867500 | ||||||||
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| Practice Location | |||||||||
| Address1: | 91 CENTRAL PARK W | ||||||||
| Address2: | APT.3F | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100234609 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2126867500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2012 | ||||||||
| LastUpdateDate: | 05/23/2012 | ||||||||
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| AuthorizedOfficialLastName: | PARAUDA | ||||||||
| AuthorizedOfficialFirstName: | MARTINA | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 2126867500 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | VETERANS ADMINISTRATION | ||||||||
| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282NC0060X | 382854-1 | NY | Y | Hospitals | General Acute Care Hospital | Critical Access |
No ID Information.