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General NPI Number Information
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NPI Number | 1255595005
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Entity Type | Organization
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Legal Business Name | STATE UNIVERSITY HOSPITAL, BROOKLYN
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Dates
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Enumeration Date | 07/10/2008
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Last Update Date | 07/10/2008
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Provider Practice Location Address
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Address Line | 119 15 230TH STREET
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City | CAMBRIA HEIGHTS
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State | NY
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Zip | 11411
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Country | US
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Telephone | 718-270-1981
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Fax |
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Provider Business Mailing Address
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Address Line | 11915 230TH ST
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City | CAMBRIA HEIGHTS
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State | NY
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Zip | 11411-2211
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Country | US
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Telephone | 718-270-1981
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Fax |
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Authorized Official
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Title or Position | ANP
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Name | MR. WILMA V KING
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Credential | MS
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Telephone | 718-270-1981
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State | NY
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