Provider Demographics
NPI:1205305331
Name:SUNSET PARK HEALTH COUNCIL, INC.
Entity type:Organization
Organization Name:SUNSET PARK HEALTH COUNCIL, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ASTRID
Authorized Official - Middle Name:P
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-630-7047
Mailing Address - Street 1:150 55TH ST
Mailing Address - Street 2:FHC ADMINISTRATION
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-2508
Mailing Address - Country:US
Mailing Address - Phone:718-630-7047
Mailing Address - Fax:718-630-8873
Practice Address - Street 1:514 49TH ST
Practice Address - Street 2:1ST FLOOR
Practice Address - City:BROOKYLN
Practice Address - State:NY
Practice Address - Zip Code:11220-2010
Practice Address - Country:US
Practice Address - Phone:718-431-2693
Practice Address - Fax:718-431-2698
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUNSET PARK HEALTH COUNCIL, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-11-19
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY037345OtherNYS PHARMACY LICENSE