Provider Demographics
NPI:1396130480
Name:MAIMONIDES MEDICAL CENTER
Entity type:Organization
Organization Name:MAIMONIDES MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:YETTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:570-954-4175
Mailing Address - Street 1:25 GILLESPIE ST
Mailing Address - Street 2:
Mailing Address - City:SWOYERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18704-3005
Mailing Address - Country:US
Mailing Address - Phone:570-954-4175
Mailing Address - Fax:
Practice Address - Street 1:25 GILLESPIE ST
Practice Address - Street 2:
Practice Address - City:SWOYERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18704-3005
Practice Address - Country:US
Practice Address - Phone:570-954-4175
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-06
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital