# NYU LUTHERAN MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538111653
- **Authorized official:** MR. GARY DELLACERRA V.P. (VP OF MANAGED CARE & REVENUE COMPLI)
- **Authorized official phone:** (718) 630-7103

## Contact information

- **Practice address:** 150 55TH ST, BROOKLYN, NY 11220-2559
- **Practice address phone:** (718) 630-7000
- **Practice address fax:** (718) 630-7437
- **Mailing address:** 5800 3RD AVE, LUTHERAN MEDICAL CENTER MANAGED CARE DEPARTMENT, BROOKLYN, NY 11220-3702
- **Mailing address phone:** (718) 630-7103
- **Mailing address fax:** (718) 630-7437

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | 7001019H | NY | Yes |

## Other

- **Enumeration date:** 05/17/2006
- **Last updated:** 08/17/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000065 | BLUE CROSS BLUE SHIELD | NY |
| 05 | — | 00243729 | — | NY |
| 05 | — | 01258300 | — | NY |
| 01 | — | 4100973 | GHI | NY |
| 01 | — | 44800 | WELLCARE | NY |
| 01 | — | 90011 | ELDERPLAN | NY |
| 01 | — | F0065 | HIP | NY |
| 01 | — | H04049 | OXFORD | NY |