Organization
KINGSBORO PSYCHIATRIC CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIO GUSTAVE M.D. (PSYCHIATRIST)
(718) 221-7161
Entity
Organization
Contact information
Practice address
681 CLARKSON AVE, BROOKLYN, NY 11203-2125
(718) 221-7161
Mailing address
215 W POPLAR ST, FLORAL PARK, NY 11001-3311
(718) 344-9126
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
232004
NY
Other
Enumeration date
10/17/2006
Last updated
08/22/2020
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