NPIMap

Organization Active NPI

St Luke'S Cornwall Hospital

  • Cognitive & Behavioral Psychologist
  • Cornwall, NY
National Provider Identifier
1124118104
Registry record updated Sep 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X
Legal business name
ST LUKE'S CORNWALL HOSPITAL
Practice address
19 Laurel Ave
St Luke'S Cornwall Hospital, Finance Dept
Cornwall, NY 12518-1403
Phone
(845) 458-4023
Fax
(845) 458-4040
NPI assigned
Oct 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jill G Barton
Title
Vice President of Finance
Phone
(845) 458-4023

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TB0200X Primary

Addresses

Primary practice location

19 Laurel Ave
St Luke'S Cornwall Hospital, Finance Dept
Cornwall, NY 12518-1403

Mailing address

19 Laurel Ave
St Luke'S Cornwall Hospital, Finance Dept
Cornwall, NY 12518-1403
Phone (845) 458-4023

Other identifiers 1

IdentifierTypeStateIssuer
02915662MedicaidNY

Other names 1

  • Behavioral Health Unit Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317340800000",
    "number": "1124118104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 LAUREL AVE",
            "address_2": "ST LUKE'S CORNWALL HOSPITAL, FINANCE DEPT",
            "city": "CORNWALL",
            "state": "NY",
            "postal_code": "125181403",
            "telephone_number": "845-458-4023",
            "fax_number": "845-458-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 LAUREL AVE",
            "address_2": "ST LUKE'S CORNWALL HOSPITAL, FINANCE DEPT",
            "city": "CORNWALL",
            "state": "NY",
            "postal_code": "125181403",
            "telephone_number": "845-458-4023",
            "fax_number": "845-458-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST LUKE'S CORNWALL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2011-09-30",
        "status": "A",
        "authorized_official_last_name": "BARTON",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "VICE PRESIDENT OF FINANCE",
        "authorized_official_telephone_number": "845-458-4023"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02915662",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Behavioral Health Unit",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Cornwall, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.