NPIMap

Organization Active NPI

Wyckoff Heights Medical Center Laboratory Services

  • Clinical Medical Laboratory
  • Brooklyn, NY
National Provider Identifier
1972110096
Registry record updated Sep 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
WYCKOFF HEIGHTS MEDICAL CENTER LABORATORY SERVICES
Practice address
374 Stockholm St
Brooklyn, NY 11237-4006
Phone
(718) 486-4136
NPI assigned
Sep 24, 2020
Organization subpart
Yes
Parent organization
WYCKOFF HEIGHTS MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 24, 2020

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

Authorized official

Name
Vali Gache
Title
Chief Financial Officer
Phone
(718) 240-1795

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

374 Stockholm St
Brooklyn, NY 11237-4006

Mailing address

374 Stockholm St
Brooklyn, NY 11237-4006

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D0726426Wyckoff Heights Medical Center374 Stockholm St, Brooklyn, NY 11237ComplianceMar 26, 2027

National Provider Directory

National Provider Directory
Tax ID family
Wykoff Heights Medical Center6 organizations share this tax ID, including this one
Part of
Wykoff Heights Medical Center

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1600905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600905600000",
    "number": "1972110096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "374 STOCKHOLM ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112374006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 STOCKHOLM ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112374006",
            "telephone_number": "718-486-4136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYCKOFF HEIGHTS MEDICAL CENTER LABORATORY SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WYCKOFF HEIGHTS MEDICAL CENTER",
        "enumeration_date": "2020-09-24",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A",
        "authorized_official_last_name": "GACHE",
        "authorized_official_first_name": "VALI",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "718-240-1795"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.