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General NPI Number Information
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NPI Number | 1972705358
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Entity Type | Organization
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Legal Business Name | MAIMONIDES HOSPITAL
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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 | 920 48TH ST
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City | BROOKLYN
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State | NY
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Zip | 11219-2918
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Country | US
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Telephone | 718-283-7830
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Fax |
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Provider Business Mailing Address
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Address Line | 4802 10TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11219-2916
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ASSISTANT VICE PRESIDENT
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Name | SANTOS RIVERA
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Credential |
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Telephone | 718-283-7325
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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 | PO61056-1
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License Number State | NY
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