Organization
HEALTHALLIANCE HOSPITAL MARYS AVENUE CAMPUS
Active
Other names
Benedictine Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PATRICK BAKER (AVP, REVENUE CYCLE)
(914) 493-2961
Entity
Organization
Contact information
Practice address
105 MARYS AVE, KINGSTON, NY 12401-5829
(845) 943-6007
(845) 943-6308
Mailing address
105 MARYS AVE, KINGSTON, NY 12401-5829
(845) 943-6007
(845) 943-6038
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000302
BLUE CROSS PROVIDER NUMBE
NY
05
—
03000199
—
NY
01
—
10005742
CDPHP PROVIDER ID
NY
01
—
103185
WELLCARE PROVIDER ID
NY
01
—
3185
GHI PROVIDER ID
NY
01
—
6450795
AETNA PROVIDER ID
NY
01
—
UV5282
MVP HEALTH PLAN ID
NY
Enumeration date
11/28/2005
Last updated
03/27/2024
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