# MMC SURGICAL CRITICAL CARE FACULTY PRACTICE PLAN

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154481802
- **Authorized official:** GAIL SIMHON (VP)
- **Authorized official phone:** (718) 283-7285

## Contact information

- **Practice address:** 4802 10TH AVE, BROOKLYN, NY 11219-2916
- **Practice address phone:** (718) 283-8773
- **Practice address fax:** (718) 283-8773
- **Mailing address:** GPO BOX 27374, NEW YORK, NY 10087-7374
- **Mailing address phone:** (718) 283-8773
- **Mailing address fax:** (718) 283-8773

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0102X | Surgical Critical Care Physician | — | NULL | Yes |
| 2086S0102X | Surgical Critical Care Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/11/2006
- **Last updated:** 09/20/2019