# ST LUKES - ROOSEVELT HOSPITAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Roosevelt Hospital Doctors Offices
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336206242
- **Authorized official:** DR. MARK GRAY M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (212) 308-1112

## Contact information

- **Practice address:** 780 8TH AVE, SUITE 303, NEW YORK, NY 10036-7017
- **Practice address phone:** (212) 641-4500
- **Practice address fax:** (212) 641-4510
- **Mailing address:** PO BOX 95000-2409, PHILADELPHIA, PA 19195-2409
- **Mailing address phone:** (212) 308-1112
- **Mailing address fax:** (212) 308-1616

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207N00000X | Dermatology Physician | — | NULL | — |
| 207N00000X | Dermatology Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | — |
| 207X00000X | Orthopaedic Surgery Physician | — | — | — |

## Other

- **Enumeration date:** 01/02/2007
- **Last updated:** 10/30/2014