Provider Demographics
NPI:1609992817
Name:THE BROOKLYN HOSPITAL CENTER
Entity Type:Organization
Organization Name:THE BROOKLYN HOSPITAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PATIENT ACCOUNTING
Authorized Official - Prefix:
Authorized Official - First Name:BERNADETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:SELBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-488-3736
Mailing Address - Street 1:270 FLATBUSH AVENUE EXT
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-3012
Mailing Address - Country:US
Mailing Address - Phone:718-260-2710
Mailing Address - Fax:718-488-3719
Practice Address - Street 1:19 ROCKWELL PL
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-1113
Practice Address - Country:US
Practice Address - Phone:718-260-2710
Practice Address - Fax:718-488-3719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00243614Medicaid