MEDICARE: UNIVERSITY HOSPITAL OF BROOKLYN SUNY DOWNSTATE HEALTH SCIENCES UNIVERS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	282N00000X	General Acute Care Hospital	7001037H	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639179328
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSITY HOSPITAL OF BROOKLYN SUNY DOWNSTATE HEALTH SCIENCES UNIVERS

Provider Business Mailing Address
First Line	:	445 LENOX RD
Second Line	:	P.O.BOX 3
City	:	BROOKLYN
State	:	NY
Zip	:	11203-2017
Country	:	US
Telephone Number	:	718-826-4901
Fax Number	:	718-826-6093

Provider Business Practice Location Address
First Line	:	445 LENOX RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11203-2017
Country	:	US
Telephone Number	:	718-826-4901
Fax Number	:	718-826-6093

Authorized Official
Title or Position	:	SR ASSOCIATE VP/DEPUTY CFO
Name	:	SEAN P SMITH
Credential	:	CPA
Telephone Number	:	718-826-4943

Provider Enumeration Date	:	07/26/2005
Last Update Date	:	07/05/2022

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