Provider Demographics
NPI:1083825194
Name:BROOKLYN PSYCHIATRIC CENTERS, INC
Entity Type:Organization
Organization Name:BROOKLYN PSYCHIATRIC CENTERS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:STRAKER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:718-875-5625
Mailing Address - Street 1:189 MONTAGUE ST
Mailing Address - Street 2:SUITE 418
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-3610
Mailing Address - Country:US
Mailing Address - Phone:718-875-5625
Mailing Address - Fax:718-875-6876
Practice Address - Street 1:189 MONTAGUE ST
Practice Address - Street 2:SUITE 300
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-3610
Practice Address - Country:US
Practice Address - Phone:718-596-9979
Practice Address - Fax:718-543-3455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00244284Medicaid
NY00244284Medicaid