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General NPI Number Information
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NPI Number | 1669674016
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Entity Type | Organization
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Legal Business Name | INTERFAITH MEDICAL CENTER
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Dates
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Enumeration Date | 06/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1545 ATLANTIC AVE
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City | BROOKLYN
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State | NY
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Zip | 11213-1122
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Country | US
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Telephone | 718-613-4982
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Fax |
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Provider Business Mailing Address
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Address Line | 154 W 70TH ST APT. 6L
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City | NEW YORK
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State | NY
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Zip | 10023-4402
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Country | US
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Telephone | 415-425-8395
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. HEATHER ELISABETH MCKEE
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Credential | PSYD
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Telephone | 718-613-4982
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number | 017119-1
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License Number State | NY
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