Healthcare Provider Details

I. General information

NPI: 1407875552
Provider Name (Legal Business Name): HEMATOLOGY ONCOLOGY ASSOC BROOKLYN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 E 14TH ST STE 401-501
BROOKLYN NY
11229-1170
US

IV. Provider business mailing address

1660 E 14TH ST STE 401-501
BROOKLYN NY
11229-1170
US

V. Phone/Fax

Practice location:
  • Phone: 718-382-8500
  • Fax: 718-382-4684
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number129436
License Number StateNY

VIII. Authorized Official

Name: MARVIN FRANKEL
Title or Position: PHARMACIST
Credential:
Phone: 718-382-8500