Provider Demographics
NPI:1689923518
Name:SUNY DOWNSTATE MEDICAL CENTER
Entity Type:Organization
Organization Name:SUNY DOWNSTATE MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC RESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MIHO
Authorized Official - Middle Name:
Authorized Official - Last Name:HATANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:347-423-6396
Mailing Address - Street 1:475 STERLING PLACE
Mailing Address - Street 2:# 2H
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:445 LENOX RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203
Practice Address - Country:US
Practice Address - Phone:718-270-1984
Practice Address - Fax:718-270-2408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-06
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren