Basic Information
| Provider Information | |||||||||
| NPI: | 1114317849 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SUNY DOWNSTATE MEDICAL CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2790 BRAGG ST | ||||||||
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| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112351146 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 450 CLARKSON AVE | ||||||||
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| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112032012 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7182702078 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/03/2015 | ||||||||
| LastUpdateDate: | 02/03/2015 | ||||||||
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| AuthorizedOfficialLastName: | ROTONDI | ||||||||
| AuthorizedOfficialFirstName: | MARGHERITA | ||||||||
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| AuthorizedOfficialTitleorPosition: | PROGRAM COORDINATOR (PEDIATRICS) | ||||||||
| AuthorizedOfficialTelephone: | 7182702078 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 281PC2000X | Y | Hospitals | Chronic Disease Hospital | Children |
No ID Information.