Provider Demographics
NPI:1043251390
Name:PARK SLOPE EMERGENCY PHYSICIAN SERVICES, PC
Entity Type:Organization
Organization Name:PARK SLOPE EMERGENCY PHYSICIAN SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:BOVE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-780-3159
Mailing Address - Street 1:PO BOX 5464
Mailing Address - Street 2:PARK SLOPE EMERGENCY PHYSICIAN SERVICES PC
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-5464
Mailing Address - Country:US
Mailing Address - Phone:800-666-2455
Mailing Address - Fax:610-617-6280
Practice Address - Street 1:506 6TH ST
Practice Address - Street 2:NEW YORK METHODIST HOSPITAL
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-3609
Practice Address - Country:US
Practice Address - Phone:718-780-3424
Practice Address - Fax:718-780-7294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00944927Medicaid
NYW12191Medicare ID - Type Unspecified