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Organization
SUNY HEALTH SCIENCE CENTER AT BROOKLYN
Active
Organization
SUNY HEALTH SCIENCE CENTER AT BROOKLYN
Active
Other names
SUNY DMC@LICH-FAMILY PRACTICE
Organization subpart
No
Provider details
NPI number
Authorized official
MARILYN VIENTOS - SOTIRIADIS (COO)
(718) 270-2025
Entity
Organization
Contact information
Practice address
97 AMITY ST, BROOKLYN, NY 11201-6004
(718) 780-1000
Mailing address
97 AMITY ST, BROOKLYN, NY 11201-6004
(718) 780-1000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207QA0000X
Adolescent Medicine (Family Medicine) Physician
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
Other
Enumeration date
03/08/2011
Last updated
04/04/2013
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