Provider Demographics
| NPI: | 1962892695 |
|---|---|
| Name: | WHITE PLAINS HOSPITAL MEDICAL CENTER |
| Entity type: | Organization |
| Organization Name: | WHITE PLAINS HOSPITAL MEDICAL CENTER |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | EVP/CMO |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | MICHAEL |
| Authorized Official - Middle Name: | J |
| Authorized Official - Last Name: | PALUMBO |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | MD |
| Authorized Official - Phone: | 914-681-1210 |
| Mailing Address - Street 1: | 41 E POST RD |
| Mailing Address - Street 2: | |
| Mailing Address - City: | WHITE PLAINS |
| Mailing Address - State: | NY |
| Mailing Address - Zip Code: | 10601-4607 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 914-681-1210 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 41 E POST RD |
| Practice Address - Street 2: | |
| Practice Address - City: | WHITE PLAINS |
| Practice Address - State: | NY |
| Practice Address - Zip Code: | 10601-4607 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 914-681-1069 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2015-02-03 |
| Last Update Date: | 2015-12-04 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| NY | 207U00000X | |
| 207RM1200X, 207UN0901X, 2085B0100X, 2085D0003X, 2085H0002X, 2085N0700X, 2085N0904X, 2085R0001X, 2085R0203X, 2085R0204X, 2085U0001X, 2085R0205X, 2085R0202X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 2085R0202X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | Group - Single Specialty |
| No | 207U00000X | Allopathic & Osteopathic Physicians | Nuclear Medicine | Group - Single Specialty | |
| No | 207RM1200X | Allopathic & Osteopathic Physicians | Internal Medicine | Magnetic Resonance Imaging (MRI) | Group - Single Specialty |
| No | 207UN0901X | Allopathic & Osteopathic Physicians | Nuclear Medicine | Nuclear Cardiology | Group - Single Specialty |
| No | 2085B0100X | Allopathic & Osteopathic Physicians | Radiology | Body Imaging | Group - Single Specialty |
| No | 2085D0003X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Neuroimaging | Group - Single Specialty |
| No | 2085H0002X | Allopathic & Osteopathic Physicians | Radiology | Hospice and Palliative Medicine | Group - Single Specialty |
| No | 2085N0700X | Allopathic & Osteopathic Physicians | Radiology | Neuroradiology | Group - Single Specialty |
| No | 2085N0904X | Allopathic & Osteopathic Physicians | Radiology | Nuclear Radiology | Group - Single Specialty |
| No | 2085R0001X | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology | Group - Single Specialty |
| No | 2085R0203X | Allopathic & Osteopathic Physicians | Radiology | Therapeutic Radiology | Group - Single Specialty |
| No | 2085R0204X | Allopathic & Osteopathic Physicians | Radiology | Vascular & Interventional Radiology | Group - Single Specialty |
| No | 2085U0001X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Ultrasound | Group - Single Specialty |
| No | 2085R0205X | Allopathic & Osteopathic Physicians | Radiology | Radiological Physics | Group - Single Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| NY | ========= | Other | EIN |
| NY | ========= | Other | EIN |