Healthcare Provider Details
I. General information
NPI: 1235282971
Provider Name (Legal Business Name): HEALTH AND HOSPITALS CORP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/18/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
348 HAWTHORNE ST
BROOKLYN NY
11225-5910
US
IV. Provider business mailing address
348 HAWTHORNE ST PH
BROOKLYN NY
11225-5910
US
V. Phone/Fax
- Phone: 718-604-2412
- Fax: 212-316-1479
- Phone: 718-604-2412
- Fax: 212-316-1479
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM2500X |
| Taxonomy | Medical Specialty Clinic/Center |
| License Number | 153323 |
| License Number State | NY |
VIII. Authorized Official
Name: DR.
GERARD
SAM
AUDIGE
Title or Position: ATTENDING PHYSICIAN
Credential: M.D.
Phone: 212-932-6513