Organization
SUNY HEALTH SCIENCE CENTER AT BROOKLYN
Active
Other names
SUNY DMC@LICH-SURGERY
Organization subpart
No
Provider details
NPI number
Authorized official
MARILYN VIENTOS - SOTIRIADIS (COO)
(718) 270-2025
Entity
Organization
Contact information
Practice address
339 HICKS ST, BROOKLYN, NY 11201-5509
(718) 780-1000
Mailing address
339 HICKS ST, BROOKLYN, NY 11201-5509
(718) 780-1000
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
2086S0120X
Pediatric Surgery Physician
—
—
2086S0127X
Trauma Surgery Physician
—
—
Other
Enumeration date
03/11/2011
Last updated
04/04/2013
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