Basic Information
| Provider Information | |||||||||
| NPI: | 1174870042 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | KINGS COUNTY HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2164 CATON AVE APT 2B | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112262555 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3472549233 | ||||||||
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| Practice Location | |||||||||
| Address1: | 451 CLARKSON AVE | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112032054 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7182453131 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2012 | ||||||||
| LastUpdateDate: | 08/10/2012 | ||||||||
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| AuthorizedOfficialLastName: | SEWELL | ||||||||
| AuthorizedOfficialFirstName: | ELIZABETH | ||||||||
| AuthorizedOfficialMiddleName: | CHRISTAL | ||||||||
| AuthorizedOfficialTitleorPosition: | NURSE PRACTITIONER | ||||||||
| AuthorizedOfficialTelephone: | 3472549233 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | NP | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 283Q00000X | 337509 | NY | Y | Hospitals | Psychiatric Hospital |
No ID Information.