Interfaith Medical Center

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R058801 Issued in NY

Legal business name

INTERFAITH MEDICAL CENTER

Practice address

1275 Bedford Ave
Ste 1
Brooklyn, NY 11216-2711

Phone

(718) 613-7401

NPI assigned

Apr 23, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Bernard Simon, LCSW-R

Title

Social Worker

Phone

(718) 613-7419

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669690152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 BEDFORD AVE",
            "address_2": "STE 1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112162711",
            "telephone_number": "718-613-7401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 BEDFORD AVE",
            "address_2": "STE 1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112162711",
            "telephone_number": "718-613-7401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERFAITH MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SIMON",
        "authorized_official_first_name": "BERNARD",
        "authorized_official_title_or_position": "SOCIAL WORKER",
        "authorized_official_telephone_number": "718-613-7419",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW-R"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R058801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Interfaith Medical Center
• Interfaith Medical Center
• Interfaith Medical Center
• Interfaith Medical Center
• Interfaith Medical Center
• Interfaith Medical Center
• Interfaith Medical Center
• Interfaith Medical Center
• Interfaith Medical Supply
• Interfaith Professional Physician Services, P.C.

• Clinical Social Worker in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Clinical Social Worker in New York

• 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.