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General NPI Number Information
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NPI Number | 1801112131
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Entity Type | Organization
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Legal Business Name | KINGSBORO PSYCHIATRIC CENTER
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Dates
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Enumeration Date | 04/12/2010
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Last Update Date | 04/12/2010
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Provider Practice Location Address
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Address Line | 681 CLARKSON AVE
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City | BROOKLYN
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State | NY
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Zip | 11203-2125
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Country | US
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Telephone | 718-257-8830
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Fax | 718-257-8831
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Provider Business Mailing Address
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Address Line | 681 CLARKSON AVENUE KINGSBORO PSYCHIATRIC CENTER
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City | BROOKLYN
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State | NY
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Zip | 11203
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Country | US
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Telephone | 718-257-8830
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Fax | 718-257-8831
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Authorized Official
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Title or Position | COMMUNITY MENTAL HEALTH NURSE
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Name | MRS. VERONICA JOHNSON
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Credential | R N
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Telephone | 718-257-7780
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | 458461-1
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License Number State | NY
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