Healthcare Provider Details

I. General information

NPI: 1992772560
Provider Name (Legal Business Name): KINGS COUNTY HOSPITAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1828 E 52ND ST
BROOKLYN NY
11234-3814
US

IV. Provider business mailing address

1828 E 52ND ST
BROOKLYN NY
11234-3814
US

V. Phone/Fax

Practice location:
  • Phone: 718-338-1042
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License NumberF304090
License Number StateNY

VIII. Authorized Official

Name: PATRICIA GUY-MOSES
Title or Position: NURSE PRACTICITONER
Credential:
Phone: 718-613-8110