Organization Active NPI

Brooklyn Endoscopy and Ambulatory Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Brooklyn, NY
National Provider Identifier
1104896430
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
7001115R Issued in NY
Legal business name
BROOKLYN ENDOSCOPY AND AMBULATORY SURGERY CENTER, LLC
Practice address
1630 E 14TH St
Brooklyn, NY 11229-1104
Phone
(718) 336-9100
Fax
(718) 336-2328
NPI assigned
Jan 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Lynn Gettenberg
Title
Excecutive Director
Phone
(718) 336-9100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 7001115R NY Primary

Addresses

Primary practice location

1630 E 14TH St
Brooklyn, NY 11229-1104

Mailing address

1630 E 14TH St
Brooklyn, NY 11229-1104
Phone (718) 336-9100

Other identifiers 1

IdentifierTypeStateIssuer
02567348MedicaidNY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104896430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 E 14TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291104",
            "telephone_number": "718-336-9100",
            "fax_number": "718-336-2328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 E 14TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291104",
            "telephone_number": "718-336-9100",
            "fax_number": "718-336-2328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKLYN ENDOSCOPY AND AMBULATORY SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GETTENBERG",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "EXCECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "718-336-9100",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NY",
            "license": "7001115R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02567348",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Aug 22, 2020; 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.