Provider Demographics
NPI:1750517744
Name:DOWNSTATE MEDICAL CENTER
Entity type:Organization
Organization Name:DOWNSTATE MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE DIRECTOR OF MEDICINE/NP
Authorized Official - Prefix:MISS
Authorized Official - First Name:JULIETH
Authorized Official - Middle Name:FAYE
Authorized Official - Last Name:MCLAUGHLIN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:718-282-7234
Mailing Address - Street 1:445 LENOX RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-2017
Mailing Address - Country:US
Mailing Address - Phone:718-282-7234
Mailing Address - Fax:718-282-7239
Practice Address - Street 1:760 PARKSIDE AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-1508
Practice Address - Country:US
Practice Address - Phone:718-282-7234
Practice Address - Fax:718-282-7239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-03
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF335407-1261QE0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0800XAmbulatory Health Care FacilitiesClinic/CenterEndoscopy