NYCDOHMH BED STUY CONNECT CMCM


Address: 20 New York Avenue, Nycdohmh Bed Stuy Connect Cmcm, Brooklyn, NY 11216-2629
Phone: 7183985005

NYCDOHMH BED STUY CONNECT CMCM (NPI# 1316993306) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1316993306
Entity Type Organization
Organization Name NYCDOHMH BED STUY CONNECT CMCM
Other Organization Name NYC DEPT OF HEALTH & MENTAL HYGIENE BED STUY CONNECT CMCM
Practice Address 20 New York Avenue
Nycdohmh Bed Stuy Connect Cmcm
Brooklyn
NY 11216-2629
Mailing Address 125 Worth Street
Nycdohmh Div of Disease Control Rm 901 Box 22
New York
NY 10013-4006
Practice Telephone 7183985005
Practice Fax Number 7183985033
Mailing Telephone 2124428468
Mailing Fax Number 2124428452
Enumeration Date 2006-05-25
Last Update Date 2020-08-22
Authorized Official Name MR. MICHAEL JAMES SMOOK (ADMINISTRATIVE MGR 3D PARTY REVENUE)
Authorized Official Telephone 2124428468
Authorized Official Credential MPA
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QC1500X Clinic/Center
Specialization: Community Health
01234404026 NY Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
NY 01234404 05

Other Provider/Organization Names

Other Name Type Code
NYC Dept of Health & Mental Hygiene Bed Stuy Connect CMCM Other Name - Individual/Organization

Office Location

Street Address 20 NEW YORK AVENUE
NYCDOHMH BED STUY CONNECT CMCM
City BROOKLYN
State NY
Zip Code 11216-2629

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Taxonomy Information

Taxonomy Code 261QC1500X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Community Health

Taxonomy Definition

Definition to come...

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Competitor

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City BROOKLYN
Zip Code 11216

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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