Healthcare Provider Details

I. General information

NPI: 1114988946
Provider Name (Legal Business Name): CLARA GIAMBRUNO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 04/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

760 BROADWAY WOODHULL MEDICAL & MENTAL HEALTH CENTER
BROOKLYN NY
11206
US

IV. Provider business mailing address

760 BROADWAY, DEPARTMENT OF PEDIATRICS ROOM 2B-321 WOODHULL MEDICAL & MENTAL HEALTH CENTER
BROOKLYN NY
11206
US

V. Phone/Fax

Practice location:
  • Phone: 718-963-8000
  • Fax: 718-630-3122
Mailing address:
  • Phone: 718-963-8214
  • Fax: 718-630-3122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number001897
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: