Provider Demographics
NPI:1457426165
Name:VASSAR BROTHERS HOSPITAL
Entity type:Organization
Organization Name:VASSAR BROTHERS HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-739-7240
Mailing Address - Street 1:1351 ROUTE 55
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LAGRANGEVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12540-5129
Mailing Address - Country:US
Mailing Address - Phone:845-339-7700
Mailing Address - Fax:845-339-2316
Practice Address - Street 1:111 MARY'S AVENUE
Practice Address - Street 2:SUITE 1
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:15401-5853
Practice Address - Country:US
Practice Address - Phone:845-339-7700
Practice Address - Fax:845-339-2316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1302001H261QX0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0203XAmbulatory Health Care FacilitiesClinic/CenterOncology, Radiation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY97Z401Medicare PIN