Provider Demographics
NPI:1124136403
Name:ST. VINCENT'S MIDTOWN HOSPITAL
Entity type:Organization
Organization Name:ST. VINCENT'S MIDTOWN HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MERTENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-459-8350
Mailing Address - Street 1:170 W 12TH ST
Mailing Address - Street 2:SMITH BUILDING 5
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-8202
Mailing Address - Country:US
Mailing Address - Phone:212-604-1732
Mailing Address - Fax:516-977-3232
Practice Address - Street 1:415 W 51ST ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-6301
Practice Address - Country:US
Practice Address - Phone:212-459-8000
Practice Address - Fax:212-459-8127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2009-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000037OtherEMPIRE BLUE CROSS
NY00243201Medicaid
NY332376Medicare ID - Type UnspecifiedDIALYSIS
NY33S230Medicare ID - Type UnspecifiedPYSCH
NY000037OtherEMPIRE BLUE CROSS