Healthcare Provider Details

I. General information

NPI: 1417029489
Provider Name (Legal Business Name): BROOKLYN BIRTHING CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 02/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2183 OCEAN AVE
BROOKLYN NY
11229-2303
US

IV. Provider business mailing address

2183 OCEAN AVE
BROOKLYN NY
11229-2303
US

V. Phone/Fax

Practice location:
  • Phone: 718-376-6655
  • Fax: 718-336-4113
Mailing address:
  • Phone: 718-376-6655
  • Fax: 718-336-4113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License Number7001289R
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. NORMA VERIDIANO
Title or Position: OWNER
Credential: MD
Phone: 646-416-1103