Organization
MAIMONIDES MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANTOS RIVERA, JR. DSW (ASSISTANT VICE PRESIDENT)
(718) 283-7325
Entity
Organization
Contact information
Practice address
920 48TH ST, RM. 1121, BROOKLYN, NY 11219-2918
(718) 283-8110
Mailing address
4802 10TH AVE, BROOKLYN, NY 11219-2916
(718) 283-6000
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
06/05/2007
Last updated
08/22/2020
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