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NPI Code Detail

MEDICARE: AMBULATORY SURGERY CENTER OF BROOKLYN, LLC

MEDICARE: AMBULATORY SURGERY CENTER OF BROOKLYN, LLC
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
1261QA1903XAmbulatory Surgical Clinic/Center7001244RNY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1609873116
Entity Type Code : Organization
Provider Name (Legal Business Name) : AMBULATORY SURGERY CENTER OF BROOKLYN, LLC
Provider Business Mailing Address
First Line : 313 43RD ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11232-3609
Country : US
Telephone Number : 718-369-1900
Fax Number : 718-965-4157
Provider Business Practice Location Address
First Line : 313 43RD ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11232-3609
Country : US
Telephone Number : 718-369-1900
Fax Number : 718-965-4157
Authorized Official
Title or Position : ADMINISTRATOR
Name : MR. FRANCIS XAVIER MONCK
Credential :
Telephone Number : 718-369-2140
Provider Enumeration Date : 06/30/2005
Last Update Date : 08/22/2020

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