Provider Demographics
NPI:1962435487
Name:BROOKLYN HOSPITAL CENTER - EMERGENCY DEPARTMENT
Entity type:Organization
Organization Name:BROOKLYN HOSPITAL CENTER - EMERGENCY DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPARTMENT CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:LISANDRO
Authorized Official - Middle Name:
Authorized Official - Last Name:IRIZARRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-250-8734
Mailing Address - Street 1:PO BOX 31724
Mailing Address - Street 2:BROOKLYN HOSPITAL CENTER
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06150-1724
Mailing Address - Country:US
Mailing Address - Phone:800-777-2455
Mailing Address - Fax:610-617-6280
Practice Address - Street 1:121 DEKALB AVENUE
Practice Address - Street 2:BROOKLYN HOSPITAL CENTER
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201
Practice Address - Country:US
Practice Address - Phone:718-250-8768
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02106747Medicaid
NYW35742Medicare ID - Type Unspecified