Basic Information
| Provider Information | |||||||||
| NPI: | 1205213725 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | CONEY ISLAND HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2601 OCEAN PKWY | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112357745 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7186163000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2601 OCEAN PKWY | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112357745 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7186163000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/05/2015 | ||||||||
| LastUpdateDate: | 05/05/2015 | ||||||||
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| AuthorizedOfficialLastName: | WAGNER | ||||||||
| AuthorizedOfficialFirstName: | ARTHUR | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 7186163000 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | HHC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251300000X | 031840 | NY | Y | Agencies | Local Education Agency (LEA) |
No ID Information.