Provider Demographics
NPI:1861499857
Name:MMC OB/GYN FPP
Entity Type:Organization
Organization Name:MMC OB/GYN FPP
Other - Org Name:MMC GYN ONCOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:FALCONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-283-8864
Mailing Address - Street 1:MMC GYN ONCOLOGY
Mailing Address - Street 2:GPO BOX 27360
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:953 49TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-2923
Practice Address - Country:US
Practice Address - Phone:718-283-7370
Practice Address - Fax:718-283-6053
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MAIMONIDES MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-07-05
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty