Basic Information
| Provider Information | |||||||||
| NPI: | 1679916803 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BROWNSVILLE COMMUNITY DEVELOPMENT CORPORATION | ||||||||
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| OtherOrganizationName: | BROWNSVILLE MULTI SERVICE FAMILY HEALTH CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 592 ROCKAWAY AVE | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112125539 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7184355000 | ||||||||
| FaxNumber: | 7183455794 | ||||||||
| Practice Location | |||||||||
| Address1: | 330 HINSDALE ST | ||||||||
| Address2: | 1ST FLOOR | ||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112074518 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3475050801 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/08/2013 | ||||||||
| LastUpdateDate: | 01/22/2015 | ||||||||
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| AuthorizedOfficialLastName: | LAWRENCE | ||||||||
| AuthorizedOfficialFirstName: | HARVEY | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT/CEO | ||||||||
| AuthorizedOfficialTelephone: | 7183455000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QF0400X | Y | Ambulatory Health Care Facilities | Clinic/Center | Federally Qualified Health Center (FQHC) |
No ID Information.