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General NPI Number Information
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NPI Number | 1255675062
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Entity Type | Organization
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Legal Business Name | BROOKLYN SC LLC
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Dates
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Enumeration Date | 11/16/2012
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 6010 BAY PARKWAY 4TH FLOOR
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City | BROOKLYN
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State | NY
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Zip | 11204
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Country | US
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Telephone | 718-259-4272
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Fax | 718-259-1582
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Provider Business Mailing Address
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Address Line | 6010 BAY PARKWAY 4TH FLOOR
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City | BROOKLYN
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State | NY
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Zip | 11204
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Country | US
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Telephone | 718-259-4272
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Fax | 718-259-1572
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Authorized Official
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Title or Position | OFFICER AND AUTHORIZED OFFICIAL
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Name | JENNIFER B. BALDOCK
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Credential |
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Telephone | 615-234-5954
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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