Provider Demographics
NPI:1902040371
Name:UNIVERSITY HOSPITAL
Entity Type:Organization
Organization Name:UNIVERSITY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SCULLION
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:315-303-4842
Mailing Address - Street 1:6 EDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BALDWINSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13027-1231
Mailing Address - Country:US
Mailing Address - Phone:315-415-5164
Mailing Address - Fax:
Practice Address - Street 1:6 EDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:BALDWINSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13027-1231
Practice Address - Country:US
Practice Address - Phone:315-415-5164
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-28
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF335656-1282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital