Organization
EMERGENCY PROVIDERS OF IMC
Active
Parent organization
INTERFAITH MEDICAL CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
INTERFAITH MEDICAL CENTER
Authorized official
LINDA MOBLEY (DIRECTOR REIMBURSEMENT)
(718) 613-4000
Entity
Organization
Contact information
Practice address
1545 ATLANTIC AVE, BROOKLYN, NY 11213-1122
(718) 613-4000
Mailing address
1545 ATLANTIC AVE, BROOKLYN, NY 11213-1122
(718) 613-4000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
—
—
207PE0005X
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
—
—
207PH0002X
Hospice and Palliative Medicine (Emergency Medicine) Physician
—
—
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
—
—
207PT0002X
Medical Toxicology (Emergency Medicine) Physician
—
—
Other
Enumeration date
04/13/2010
Last updated
04/13/2010
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