Provider Demographics
NPI:1316681430
Name:BROWNSVILLE COMMUNITY DEVELOPMENT CORPORATION
Entity type:Organization
Organization Name:BROWNSVILLE COMMUNITY DEVELOPMENT CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-345-6366
Mailing Address - Street 1:592 ROCKAWAY AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11212-5539
Mailing Address - Country:US
Mailing Address - Phone:718-345-5000
Mailing Address - Fax:718-345-5794
Practice Address - Street 1:407 DUMONT AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-7359
Practice Address - Country:US
Practice Address - Phone:347-842-2888
Practice Address - Fax:347-418-4410
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BROWNSVILLE COMMUNITY DEVELOPMENT CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-04-25
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care