Provider Demographics
NPI:1437372158
Name:YESHIVA UNIVERSITY
Entity type:Organization
Organization Name:YESHIVA UNIVERSITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR FISHER LANDAU CENTER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:S
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:718-430-3908
Mailing Address - Street 1:1165 MORRIS PARK AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-1915
Mailing Address - Country:US
Mailing Address - Phone:718-430-3906
Mailing Address - Fax:
Practice Address - Street 1:1165 MORRIS PARK AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1915
Practice Address - Country:US
Practice Address - Phone:718-430-3906
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016178283XC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283XC2000XHospitalsRehabilitation HospitalChildren