Provider Demographics
NPI:1336520048
Name:NEW YORK PRESBYTERIAN HOSPITAL
Entity type:Organization
Organization Name:NEW YORK PRESBYTERIAN HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIEITIAN
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:KIM
Authorized Official - Last Name:FISHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS RD CDN
Authorized Official - Phone:212-342-3289
Mailing Address - Street 1:7 EAST AVE
Mailing Address - Street 2:5M
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538-2443
Mailing Address - Country:US
Mailing Address - Phone:732-261-1404
Mailing Address - Fax:
Practice Address - Street 1:622 W 168TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3720
Practice Address - Country:US
Practice Address - Phone:212-342-3289
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-18
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1095453133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty