# KINGSBROOK PRACTICE PLAN

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

## Provider details

- **NPI number:** 1417132390
- **Authorized official:** DR. MARC K. ROSS M.D. (DIRECTOR)
- **Authorized official phone:** (212) 563-2497

## Contact information

- **Practice address:** 585 SCHENECTADY AVE, BROOKLYN, NY 11203-1809
- **Practice address phone:** (212) 563-2497
- **Practice address fax:** (212) 563-0605
- **Mailing address:** 158 W 27TH ST, 11TH FL S, NEW YORK, NY 10001-6216
- **Mailing address phone:** (212) 563-2497

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/09/2008
- **Last updated:** 10/24/2008