Organization
BETH ISRAEL AMBULATORY CARE SERVICES CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN COLLURA (EXECUTIVE VICE PRESIDENT & CFO)
(212) 636-8468
Entity
Organization
Contact information
Practice address
3121 KINGS HIGHWAY, BETH ISRAEL AMBULATORY CARE SERVICES CORP, BROOKLYN, NY 11234-2644
(212) 256-3296
(212) 256-3595
Mailing address
160 WATER ST, 24TH FLOOR ATTN: JILLIAN SUMPTER, NEW YORK, NY 10038-4922
(212) 256-3296
(212) 256-3595
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
7001269P
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003611
BLUE CROSS
NY
05
—
01660526
—
NY
Enumeration date
12/19/2006
Last updated
09/09/2015
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