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Organization

SUNY HEALTH SCIENCE CENTER AT BROOKLYN

Active
Other names
SUNY DMC@LICH-EMERGENCY MEDICINE
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
207P00000X
Emergency Medicine Physician
Primary
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
207PT0002X
Medical Toxicology (Emergency Medicine) Physician

Other

Enumeration date
03/11/2011
Last updated
04/04/2013
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