Provider Demographics
NPI:1891112868
Name:LUTHERAN MEDICAL CENTER-NES
Entity type:Organization
Organization Name:LUTHERAN MEDICAL CENTER-NES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMERGENCY DEPARTMENT DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-630-6787
Mailing Address - Street 1:2 5TH AVE APT 2D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-8832
Mailing Address - Country:US
Mailing Address - Phone:914-393-2368
Mailing Address - Fax:
Practice Address - Street 1:150 55TH STREET STATION 3-03
Practice Address - Street 2:OFFICE OF EMERGENCY DEPT-- REBECCA TURNER
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220
Practice Address - Country:US
Practice Address - Phone:718-630-8371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-27
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY267791282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital