MEDICARE: BROOKDALE HOSPITAL

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	282NW0100X	Women's Hospital	011900-1	NY

General Provider Information

NPI Number	:	1922288901
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BROOKDALE HOSPITAL

Provider Business Mailing Address
First Line	:	1 BROOKDALE PLZ
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11212-3139
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 BROOKDALE PLZ
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11212-3139
Country	:	US
Telephone Number	:	718-240-5978
Fax Number	:

Authorized Official
Title or Position	:	CHAIRMAN OF OB/GYN
Name	:	MARK SPITZER
Credential	:	MD
Telephone Number	:	718-240-5978

Provider Enumeration Date	:	11/07/2007
Last Update Date	:	11/07/2007

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