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Organization

BROOKDALE UNIVERSITY MEDICAL CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SUJANA DONTUKURTHY M.D (PGY1)
(917) 902-1779
Entity
Organization

Contact information

Practice address
1 BROOKDALE PLZ, BROOKLYN, NY 11212-3139
(718) 986-4075
Mailing address
1 BROOKDALE PLZ, BROOKLYN, NY 11212-3139
(718) 986-4075

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
YLF87920583
EMPIRE BLUECROSS BLUE SHIELD
NY
Enumeration date
04/28/2014
Last updated
04/28/2014
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