Provider Demographics
NPI:1861759961
Name:PHELPS MEMORIAL HOSPITAL ASSOCIATION
Entity type:Organization
Organization Name:PHELPS MEMORIAL HOSPITAL ASSOCIATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PROFESSIONAL BILLING
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:A
Authorized Official - Last Name:RYKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-366-3134
Mailing Address - Street 1:362 NORTH BROADWAY, 2ND FLOOR
Mailing Address - Street 2:PHELPS MEDICAL PRACTICE
Mailing Address - City:SLEEPY HOLLOW
Mailing Address - State:NY
Mailing Address - Zip Code:10591-1096
Mailing Address - Country:US
Mailing Address - Phone:914-631-2070
Mailing Address - Fax:
Practice Address - Street 1:18 ASHFORD AVENUE
Practice Address - Street 2:PHELPS AT DOBBS FERRY
Practice Address - City:DOBBS FERRY
Practice Address - State:NY
Practice Address - Zip Code:10522-1800
Practice Address - Country:US
Practice Address - Phone:914-478-1384
Practice Address - Fax:914-478-1387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-13
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty