Healthcare Provider Details

I. General information

NPI: 1841465218
Provider Name (Legal Business Name): THE BROOKDALE HOSPITAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2008
Last Update Date: 11/13/2024
Certification Date: 11/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

585 SCHENECTADY AVE
BROOKLYN NY
11203-1851
US

IV. Provider business mailing address

10101 AVENUE D
BROOKLYN NY
11236-1902
US

V. Phone/Fax

Practice location:
  • Phone: 718-604-5532
  • Fax: 718-604-5527
Mailing address:
  • Phone: 718-240-8534
  • Fax: 718-240-6492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number7001033H
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: CHARLES SALVO
Title or Position: SENIOR VICE PRESIDENT
Credential:
Phone: 718-240-6374