Provider Demographics
NPI:1154362119
Name:ST VINCENTS PSYCHIATRIC ASSOCIATES
Entity type:Organization
Organization Name:ST VINCENTS PSYCHIATRIC ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT, OPERATIONS
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:KASTAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-604-1571
Mailing Address - Street 1:PO BOX 6217
Mailing Address - Street 2:CHURCH ST STATION
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10249-6217
Mailing Address - Country:US
Mailing Address - Phone:800-207-5737
Mailing Address - Fax:610-401-2100
Practice Address - Street 1:203 W 12TH ST
Practice Address - Street 2:ROOM 603
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-7762
Practice Address - Country:US
Practice Address - Phone:212-604-8803
Practice Address - Fax:212-604-8794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01194696Medicaid
NYW16961Medicare ID - Type Unspecified