MEDICARE: SHEEPSHEAD BAY WOMEN CC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1376540344
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHEEPSHEAD BAY WOMEN CC

Provider Business Mailing Address
First Line	:	PO BOX 27360
Second Line	:	MMC OB/GYN FPP
City	:	BROOKLYN
State	:	NY
Zip	:	11202-7360
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1616A VOORHIES AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-3914
Country	:	US
Telephone Number	:	718-616-1268
Fax Number	:	718-616-1281

Authorized Official
Title or Position	:	BUSINESS MANAGER
Name	:	VICTORIA FALCONE
Credential	:
Telephone Number	:	718-283-8864

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	08/22/2020

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Directions to “SHEEPSHEAD BAY WOMEN CC ” Practice Location

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