Basic Information
| Provider Information | |||||||||
| NPI: | 1477115251 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WYCKOFF HEIGHTS MEDICAL CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 559 FOX ST | ||||||||
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| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104553527 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3473017398 | ||||||||
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| Practice Location | |||||||||
| Address1: | 374 STOCKHOLM ST | ||||||||
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| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112374006 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189637272 | ||||||||
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| ProviderEnumerationDate: | 07/02/2019 | ||||||||
| LastUpdateDate: | 07/02/2019 | ||||||||
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| AuthorizedOfficialLastName: | SIKORSKA | ||||||||
| AuthorizedOfficialFirstName: | JOLANTA | ||||||||
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| AuthorizedOfficialTitleorPosition: | ASSISTANT DIRECTOR, CREDENTIALS | ||||||||
| AuthorizedOfficialTelephone: | 7189636466 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207PE0004X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine | Emergency Medical Services |
No ID Information.