Organization
BROOKDALE HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TATYANA SEMENOVA MD (PHISICIAN)
(347) 277-9084
Entity
Organization
Contact information
Practice address
2258 84TH ST, BROOKLYN, NY 11214-3328
(347) 277-9084
Mailing address
2258 84TH ST, BROOKLYN, NY 11214-3328
(347) 277-9084
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
2592091
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2592091
STATE OF NEW YORK
NY
Enumeration date
11/09/2010
Last updated
11/09/2010
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