MEDICARE: SUNY DOWNSTATE

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	282NR1301X	Rural Acute Care Hospital		NY

General Provider Information

NPI Number	:	1750657847
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNY DOWNSTATE

Provider Business Mailing Address
First Line	:	7420 RIDGE BLVD
Second Line	:	APT 1C
City	:	BROOKLYN
State	:	NY
Zip	:	11209-2356
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7420 RIDGE BLVD
Second Line	:	APT 1C
City	:	BROOKLYN
State	:	NY
Zip	:	11209-2356
Country	:	US
Telephone Number	:	787-342-9284
Fax Number	:

Authorized Official
Title or Position	:	RESIDENT
Name	:	DR. RUBEN XAVIER PAGAN
Credential	:	MD
Telephone Number	:	787-342-9284

Provider Enumeration Date	:	03/22/2012
Last Update Date	:	03/22/2012

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Directions to “SUNY DOWNSTATE ” Practice Location

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