Basic Information
Provider Information
NPI: 1285838144
EntityType: 2
ReplacementNPI:  
OrganizationName: WOODHULL HOSPITAL
LastName:  
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Mailing Information
Address1: 1528 WASHINGTON AVE
Address2:  
City: NEW HYDE PARK
State: NY
PostalCode: 110404333
CountryCode: US
TelephoneNumber: 5162702690
FaxNumber: 7186303138
Practice Location
Address1: 760 BROADWAY
Address2: WOODHULL HOSPITAL
City: BROOKLYN
State: NY
PostalCode: 112065317
CountryCode: US
TelephoneNumber: 7189638695
FaxNumber: 7186303138
Other Information
ProviderEnumerationDate: 06/13/2007
LastUpdateDate: 08/22/2020
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: THOMAS
AuthorizedOfficialFirstName: SANTHOSH
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AuthorizedOfficialTitleorPosition: SENIOR SOCIAL WORKER
AuthorizedOfficialTelephone: 7189638695
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: LMSW
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
282N00000X070649-1NYY HospitalsGeneral Acute Care Hospital 

No ID Information.


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