Organization
WYCKOFF HIEGHTS MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELANA YUSUPOVA (PHYSICIAN ASSISTANT)
(917) 209-5745
Entity
Organization
Contact information
Practice address
374 STOCKHOLM ST, BROOKLYN, NY 11237-4006
(718) 963-7266
Mailing address
8311 139TH ST APT 1H, JAMAICA, NY 11435-1602
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
1076588
NY
Other
Enumeration date
11/18/2009
Last updated
11/18/2009
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