Active NPI
Wyckoff Heights Medical Center
- Clinic/Center
- Brooklyn, NY
National Provider Identifier
1104379593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- Legal business name
- WYCKOFF HEIGHTS MEDICAL CENTER
- Practice address
- 545 Christopher Ave
Brooklyn, NY 11212-7029 - Phone
- (347) 466-6341
- NPI assigned
- Aug 2, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Desiree Bullock
- Title
- Clinical Supervisor
- Phone
- (347) 466-6341
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Primary |
Addresses
Primary practice location
545 Christopher Ave
Brooklyn, NY 11212-7029
Mailing address
545 Christopher Ave
Brooklyn, NY 11212-7029
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RO40749-1 | Other | NY | LICENSE NUMBER |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470096000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1470096000000",
"number": "1104379593",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "545 CHRISTOPHER AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112127029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "545 CHRISTOPHER AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112127029",
"telephone_number": "347-466-6341"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WYCKOFF HEIGHTS MEDICAL CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2016-08-02",
"last_updated": "2016-08-02",
"status": "A",
"authorized_official_last_name": "BULLOCK",
"authorized_official_first_name": "DESIREE",
"authorized_official_title_or_position": "CLINICAL SUPERVISOR",
"authorized_official_telephone_number": "347-466-6341"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "RO40749-1",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.