Active NPI
St. Anthony Community Hospital
- Cardiovascular Disease Physician
- Warwick, NY
National Provider Identifier
1396043501
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 105585
- Legal business name
- ST. ANTHONY COMMUNITY HOSPITAL
- Practice address
- 15 Maple Ave
Warwick, NY 10990-1028 - Phone
- (845) 986-2276
- NPI assigned
- Mar 11, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Nancy Vandemark
- Title
- Administrative Director
- Phone
- (845) 987-3952
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 105585 | NY | Primary |
Addresses
Primary practice location
15 Maple Ave
Warwick, NY 10990-1028
Mailing address
20 Grand St
3Rd Floor
Warwick, NY 10990-1035
Phone (866) 474-3900
Other names 1
- SACH Professional
National Provider Directory
National Provider DirectoryLocations
55 Ronald Reagan Blvd
Warwick, NY 10990
Phone (845) 986-4949
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1299801600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1505174400000",
"number": "1396043501",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 GRAND ST",
"address_2": "3RD FLOOR",
"city": "WARWICK",
"state": "NY",
"postal_code": "109901035",
"telephone_number": "866-474-3900",
"fax_number": "845-987-5979"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 MAPLE AVE",
"city": "WARWICK",
"state": "NY",
"postal_code": "109901028",
"telephone_number": "845-986-2276"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ST. ANTHONY COMMUNITY HOSPITAL",
"organizational_subpart": "NO",
"enumeration_date": "2011-03-11",
"last_updated": "2017-09-12",
"status": "A",
"authorized_official_last_name": "VANDEMARK",
"authorized_official_first_name": "NANCY",
"authorized_official_title_or_position": "ADMINISTRATIVE DIRECTOR",
"authorized_official_telephone_number": "845-987-3952",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "NY",
"license": "105585",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "SACH Professional",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Warwick, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.