NPIMap

Organization Active NPI

Suny Health Science Center at Brooklyn

Doing business as Suny DMC@Lich-Urology

  • Urology Physician
  • Brooklyn, NY
National Provider Identifier
1104124379
Registry record updated Apr 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
SUNY HEALTH SCIENCE CENTER AT BROOKLYN
Doing business as
Suny DMC@Lich-Urology
Practice address
339 Hicks St
Brooklyn, NY 11201-5509
Phone
(718) 780-1000
NPI assigned
Mar 11, 2011
Last updated
Apr 4, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Marilyn Vientos - Sotiriadis
Title
Coo
Phone
(718) 270-2025

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208800000X Primary
Pediatric Urology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2088P0231X

Addresses

Primary practice location

339 Hicks St
Brooklyn, NY 11201-5509

Mailing address

339 Hicks St
Brooklyn, NY 11201-5509
Phone (718) 780-1000

Other names 1

  • SUNY DMC@LICH-UROLOGY Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1299801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365033600000",
    "number": "1104124379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "339 HICKS ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015509",
            "telephone_number": "718-780-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 HICKS ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015509",
            "telephone_number": "718-780-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNY HEALTH SCIENCE CENTER AT BROOKLYN",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-11",
        "last_updated": "2013-04-04",
        "status": "A",
        "authorized_official_last_name": "VIENTOS - SOTIRIADIS",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "718-270-2025"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2088P0231X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Urology, Pediatric Urology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SUNY DMC@LICH-UROLOGY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.