Provider Demographics
NPI:1093431850
Name:THE BROOKLYN HOSPITAL CENTER
Entity Type:Organization
Organization Name:THE BROOKLYN HOSPITAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP REVENUE ENHANCEMENT
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:P
Authorized Official - Last Name:MINARCIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-488-3775
Mailing Address - Street 1:121 DEKALB AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201
Mailing Address - Country:US
Mailing Address - Phone:718-488-3775
Mailing Address - Fax:
Practice Address - Street 1:86 FLEET PLACE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201
Practice Address - Country:US
Practice Address - Phone:718-250-7998
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE BROOKLYN HOSPITAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00243614Medicaid