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NPI Code Detail

MEDICARE: SUNY DOWNSTATE MEDICAL CENTER

MEDICARE: SUNY DOWNSTATE MEDICAL CENTER
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
1207PE0004XEmergency Medical Services (Emergency Medicine) Physician
2207PP0204XPediatric Emergency Medicine (Emergency Medicine) Physician
3207P00000XEmergency Medicine Physician

Other Identifiers

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

General Provider Information

NPI Number : 1699704155
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUNY DOWNSTATE MEDICAL CENTER
Provider Business Mailing Address
First Line : 445 LENOX RD
Second Line :
City : BROOKLYN
State : NY
Zip : 11203-2017
Country : US
Telephone Number : 718-270-1000
Fax Number :
Provider Business Practice Location Address
First Line : 445 LENOX RD
Second Line :
City : BROOKLYN
State : NY
Zip : 11203-2017
Country : US
Telephone Number : 718-270-1000
Fax Number :
Authorized Official
Title or Position : COO
Name : MARILYN VIENTOS-SOTIRIADIS
Credential :
Telephone Number : 718-270-2025
Provider Enumeration Date : 06/30/2006
Last Update Date : 04/04/2013

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Directions to “SUNY DOWNSTATE MEDICAL CENTER ” Practice Location

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