Provider Demographics
NPI:1730213042
Name:BELLEVUE HOSPITAL CENTER
Entity type:Organization
Organization Name:BELLEVUE HOSPITAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, HCASE MANAGEMENT SERVICES
Authorized Official - Prefix:DR
Authorized Official - First Name:DEEPAK
Authorized Official - Middle Name:PRAKASH
Authorized Official - Last Name:SIDHAR
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:212-562-5131
Mailing Address - Street 1:462 1ST AVE
Mailing Address - Street 2:ROOM # 12 EAST 12
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-9196
Mailing Address - Country:US
Mailing Address - Phone:212-562-5131
Mailing Address - Fax:212-562-2702
Practice Address - Street 1:462 1ST AVE
Practice Address - Street 2:ROOM # 12 EAST 12
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-9196
Practice Address - Country:US
Practice Address - Phone:212-562-5131
Practice Address - Fax:212-562-2702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01955884Medicaid