Healthcare Provider Details

I. General information

NPI: 1043417017
Provider Name (Legal Business Name): MAIMONIDES MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

948 48TH ST 2ND FLOOR
BROOKLYN NY
11219-2918
US

IV. Provider business mailing address

948 48TH ST 2ND FLOOR
BROOKLYN NY
11219-2918
US

V. Phone/Fax

Practice location:
  • Phone: 718-283-7219
  • Fax: 718-635-7149
Mailing address:
  • Phone: 718-283-7219
  • Fax: 718-635-7149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number218810
License Number StateNY

VIII. Authorized Official

Name: MS. DENISE GIANNONE
Title or Position: FLOOR MANGER, OFFICE MANGER
Credential:
Phone: 718-283-7219