Provider Demographics
NPI:1528275591
Name:SUNY DOWNSTATE MED CENTER
Entity type:Organization
Organization Name:SUNY DOWNSTATE MED CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TH. PHYSICAL THERAPIST II
Authorized Official - Prefix:
Authorized Official - First Name:YEHIA
Authorized Official - Middle Name:S
Authorized Official - Last Name:OSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:718-270-2811
Mailing Address - Street 1:445 LENOX RD
Mailing Address - Street 2:BOX 30
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-2017
Mailing Address - Country:US
Mailing Address - Phone:718-270-2811
Mailing Address - Fax:718-270-1247
Practice Address - Street 1:445 LENOX RD
Practice Address - Street 2:BOX 30
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2017
Practice Address - Country:US
Practice Address - Phone:718-270-2811
Practice Address - Fax:718-270-1247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018595-1283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital