Provider Demographics
NPI:1710979109
Name:SHEEPSHEAD BAY SURGERY CENTER, INC.
Entity Type:Organization
Organization Name:SHEEPSHEAD BAY SURGERY CENTER, INC.
Other - Org Name:SHEEPSHEAD BAY SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SILBERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-787-0387
Mailing Address - Street 1:2269 OCEAN AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-3103
Mailing Address - Country:US
Mailing Address - Phone:718-787-0387
Mailing Address - Fax:718-787-0388
Practice Address - Street 1:2269 OCEAN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-3103
Practice Address - Country:US
Practice Address - Phone:718-787-0387
Practice Address - Fax:718-787-0388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-22
Last Update Date:2017-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7001288R261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01972852Medicaid
NY01972852Medicaid
NY490004740Medicare UPIN