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General NPI Number Information
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NPI Number | 1114950490
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Entity Type | Organization
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Legal Business Name | NORTH BROOKLYN HEALTH NETWORK
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 760 BROADWAY
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City | BROOKLYN
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State | NY
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Zip | 11206-5317
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Country | US
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Telephone | 718-963-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 4611 7TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11220-1412
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ATTENDING PHYSICIAN
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Name | DR. JUAN F CRUZATTE
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Credential | MD
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Telephone | 718-851-4540
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 171095
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License Number State | NY
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