| Dr. Betty Shabazz Health Center | |
|
999 Blake Ave Brooklyn NY 11208-3535 | |
| (718) 277-8303 | |
| (718) 277-4795 |
| Full Name | Dr. Betty Shabazz Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 999 Blake Ave, Brooklyn, New York |
| Authorized Official Name and Position | Alan J. Wengrofsky (CFO) |
| Authorized Official Contact | 2125452481 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Betty Shabazz Health Center 60 Madison Ave Floor 5 New York NY 10010-1600 Ph: (212) 545-2439 | Dr. Betty Shabazz Health Center 999 Blake Ave Brooklyn NY 11208-3535 Ph: (718) 277-8303 |
| NPI Number | 1154498822 |
|---|---|
| Provider Enumeration Date | 11/29/2006 |
| Last Update Date | 06/15/2016 |
| Medicare PECOS PAC ID | 7416855143 |
|---|---|
| Medicare Enrollment ID | O20040709000876 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154498822 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (New York) | Primary |
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