Provider Demographics
NPI:1801204995
Name:NEW YORK METHODIST HOSPITAL
Entity type:Organization
Organization Name:NEW YORK METHODIST HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PA SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WILKOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-780-5942
Mailing Address - Street 1:46 EAST DR
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-1927
Mailing Address - Country:US
Mailing Address - Phone:516-567-8134
Mailing Address - Fax:
Practice Address - Street 1:506 6TH STREET
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-9008
Practice Address - Country:US
Practice Address - Phone:718-780-5942
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-01
Last Update Date:2014-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017591281P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes281P00000XHospitalsChronic Disease Hospital