| Nycdohmh Bed Stuy Connect Cmcm | |
|
20 New York Avenue Nycdohmh Bed Stuy Connect Cmcm Brooklyn NY 11216-2629 | |
| (718) 398-5005 | |
| (718) 398-5033 |
| Full Name | Nycdohmh Bed Stuy Connect Cmcm |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 20 New York Avenue, Brooklyn, New York |
| Authorized Official Name and Position | Michael James Smook (ADMINISTRATIVE MGR 3D PARTY REVENUE) |
| Authorized Official Contact | 2124428468 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nycdohmh Bed Stuy Connect Cmcm 125 Worth Street Nycdohmh Div Of Disease Control Rm 901 Box 22 New York NY 10013-4006 Ph: (212) 442-8468 | Nycdohmh Bed Stuy Connect Cmcm 20 New York Avenue Nycdohmh Bed Stuy Connect Cmcm Brooklyn NY 11216-2629 Ph: (718) 398-5005 |
| NPI Number | 1316993306 |
|---|---|
| Provider Enumeration Date | 05/25/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316993306 | NPI | - | NPPES |
| 01234404 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | 01234404026 (New York) | Primary |
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