Organization
JEROME STREET CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER CAMPANELLI PSY.D. (CEO)
(212) 385-3030
Entity
Organization
Contact information
Practice address
971 JEROME ST, BROOKLYN, NY 11207-9252
(718) 272-3300
Mailing address
971 JEROME ST, BROOKLYN, NY 11207-9252
(718) 272-3300
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01551404
—
NY
Enumeration date
03/13/2007
Last updated
08/22/2020
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