Basic Information
Provider Information
NPI: 1760847826
EntityType: 2
ReplacementNPI:  
OrganizationName: ST. JOSEPH'S HOSPITAL, YONKERS
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: ST. JOSEPH'S MEDICAL CENTER
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 127 S BROADWAY
Address2:  
City: YONKERS
State: NY
PostalCode: 107014006
CountryCode: US
TelephoneNumber: 9143787000
FaxNumber:  
Practice Location
Address1: 127 S BROADWAY
Address2:  
City: YONKERS
State: NY
PostalCode: 107014006
CountryCode: US
TelephoneNumber: 9143787000
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/16/2015
LastUpdateDate: 12/16/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: SPICER
AuthorizedOfficialFirstName: MICHAEL
AuthorizedOfficialMiddleName: J.
AuthorizedOfficialTitleorPosition: PRESIDENT & CHIEF EXECUTIVE OFFICER
AuthorizedOfficialTelephone: 9143787485
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
282N00000X NYY HospitalsGeneral Acute Care Hospital 

No ID Information.


Home