Healthcare Provider Details

I. General information

NPI: 1336224609
Provider Name (Legal Business Name): BROOKLYN CHILDREN CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9128 84TH ST
WOODHAVEN NY
11421-2929
US

IV. Provider business mailing address

9128 84TH ST
WOODHAVEN NY
11421-2929
US

V. Phone/Fax

Practice location:
  • Phone: 718-296-1819
  • Fax:
Mailing address:
  • Phone: 718-296-1819
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License NumberP47582
License Number StateNY

VIII. Authorized Official

Name: DR. ARTURO OLAECHEA
Title or Position: PSYCHIATRIST
Credential: MD
Phone: 718-221-4500