Organization
HEALTHALLIANCE HOSPITAL MARYS AVENUE CAMPUS
Active
Organization
HEALTHALLIANCE HOSPITAL MARYS AVENUE CAMPUS
Active
Other names
Benedictine Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARIO DIFIGLIA FHFMA (VICE PRESIDENT)
(914) 493-7909
Entity
Organization
Contact information
Practice address
105 MARYS AVE, KINGSTON, NY 12401-5848
(845) 943-6007
(845) 943-6038
Mailing address
105 MARYS AVE, KINGSTON, NY 12401-5829
(845) 943-6007
(845) 943-6038
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000702
BLUE CROSS PROVIDER NUMBE
NY
05
—
00274020
—
NY
01
—
10005742
CDPHP PROVIDER ID
NY
01
—
103185
WELLCARE PROV ID
NY
01
—
143278
VALUE OPTIONS PROV ID
NY
01
—
3185
GHI PROVIDER ID
NY
01
—
6450795
AETNA PROV ID
NY
01
—
UV5282
MVP HEALTH PLAN PROV ID
NY
Enumeration date
03/08/2006
Last updated
03/27/2025
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