Provider Demographics
NPI:1639212202
Name:NORTH BROOKLYN HEALTH NETWORK
Entity Type:Organization
Organization Name:NORTH BROOKLYN HEALTH NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D
Authorized Official - Prefix:DR
Authorized Official - First Name:EVLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:OPOKU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-963-8000
Mailing Address - Street 1:445 NEW JERSEY AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207-4110
Mailing Address - Country:US
Mailing Address - Phone:347-405-9407
Mailing Address - Fax:
Practice Address - Street 1:760 BROADWAY
Practice Address - Street 2:6TH FLR ADMINISTRATION
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-5317
Practice Address - Country:US
Practice Address - Phone:718-963-8000
Practice Address - Fax:718-963-7957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF380858261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service