Healthcare Provider Details

I. General information

NPI: 1194053645
Provider Name (Legal Business Name): THE BROOKDALE HOSPITAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2009
Last Update Date: 11/08/2024
Certification Date: 11/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BROOKDALE PLZ
BROOKLYN NY
11212-3139
US

IV. Provider business mailing address

1 BROOKDALE PLZ
BROOKLYN NY
11212-3139
US

V. Phone/Fax

Practice location:
  • Phone: 718-240-6281
  • Fax: 718-240-6682
Mailing address:
  • Phone: 718-240-5741
  • Fax: 718-240-6682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS0112X
TaxonomyOral and Maxillofacial Surgery Clinic/Center
License Number
License Number StateNY

VIII. Authorized Official

Name: MICHELLE FIGUEROA
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 718-240-5741