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General NPI Number Information
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NPI Number | 1922434216
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Entity Type | Organization
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Legal Business Name | SUNY DOWNSTATE
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Dates
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Enumeration Date | 09/19/2013
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Last Update Date | 09/19/2013
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Provider Practice Location Address
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Address Line | 450 CLARKSON AVE BOX 49
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City | BROOKLYN
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State | NY
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Zip | 11203-2012
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Country | US
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Telephone | 718-270-2078
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Fax |
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Provider Business Mailing Address
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Address Line | 910 SAINT JOHNS PL APT 2
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City | BROOKLYN
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State | NY
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Zip | 11216-4306
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Country | US
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Telephone | 631-408-6128
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Fax |
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | DR. HENRY SCHAEFFER
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Credential |
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Telephone | 718-270-2078
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC2000X
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Taxonomy Name | Children's Hospital
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License Number |
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License Number State |
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