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General NPI Number Information
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NPI Number | 1386691822
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Entity Type | Organization
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Legal Business Name | UNIVERSITY PHYSICIANS OF BROOKLYN, INC.
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Dates
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Enumeration Date | 05/30/2006
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Last Update Date | 05/28/2024
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Provider Practice Location Address
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Address Line | 450 CLARKSON AVE ALL1-452
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City | BROOKLYN
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State | NY
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Zip | 11203-2056
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Country | US
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Telephone | 718-270-2045
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Fax | 718-270-3763
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Provider Business Mailing Address
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Address Line | 450 CLARKSON AVE MSC#80
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City | BROOKLYN
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State | NY
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Zip | 11203-2056
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Country | US
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Telephone | 718-613-8481
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Fax | 718-613-8498
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Authorized Official
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Title or Position | ENROLLMENT MANAGER
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Name | ALBERT GUIDICE
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Credential |
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Telephone | 718-613-8481
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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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 | 207XP3100X
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Taxonomy Name | Pediatric Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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