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NPI 1194748624

NPI 1194748624 : LINDSEY CAROLINE DOUGLAS MD : BROOKLYN, NY

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General NPI Number Information
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    NPI Number           |    1194748624
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    Entity Type          |    Individual 
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    Provider Name        |    LINDSEY CAROLINE DOUGLAS MD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/25/2006
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    Last Update Date     |    07/27/2021
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Provider Practice Location Address
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    Address Line         |    4802 10TH AVENUE 
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    City                 |    BROOKLYN
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    State                |    NY
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    Zip                  |    11219
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    Country              |    US
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    Telephone            |    718-283-7500
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    Fax                  |    718-635-6149
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Provider Business Mailing Address
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    Address Line         |    977 48TH STREET 
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    City                 |    BROOKLYN
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    State                |    NY
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    Zip                  |    11219
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    Country              |    US
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    Telephone            |    718-283-8015
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    Fax                  |    718-635-7235
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    208000000X
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    Taxonomy Name        |    Pediatrics Physician
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    License Number       |    240745
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    License Number State |    NY
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