Provider Demographics
NPI:1740853340
Name:UNIVERSITY HOSPITAL OF BROOKLYN SUNY DOWNSTATE HEALTH SCIENCES UNIVERS
Entity type:Organization
Organization Name:UNIVERSITY HOSPITAL OF BROOKLYN SUNY DOWNSTATE HEALTH SCIENCES UNIVERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR AVP PRESIDENT & DEPUTY CFO
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-826-4943
Mailing Address - Street 1:711 PARKSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-1507
Mailing Address - Country:US
Mailing Address - Phone:718-826-4943
Mailing Address - Fax:
Practice Address - Street 1:470 CLARKSON AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2012
Practice Address - Country:US
Practice Address - Phone:718-270-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-21
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty