Organization
DEPARTMENT OF EDUCATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. IDOWU MEDINA MORAFA RN (STAFF NURSE)
(718) 705-2873
Entity
Organization
Contact information
Practice address
923 ELTON STREET, 2ND FLOOR, BROOKLYN, NY 11208
(718) 705-2873
Mailing address
923 ELTON ST, 2ND FLOOR, BROOKLYN, NY 11208-5315
(718) 705-2873
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
709865
NY
282NC0060X
Critical Access Hospital
709865
NY
3140N1450X
Pediatric Skilled Nursing Facility
Primary
709865
NY
Other
Enumeration date
02/24/2017
Last updated
02/24/2017
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