Basic Information
Provider Information
NPI: 1407155161
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WOOLBRIGHT
FirstName: WILLIAM
MiddleName: CHARLES
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 703 MAIN ST
Address2:  
City: PATERSON
State: NJ
PostalCode: 075032621
CountryCode: US
TelephoneNumber: 9737542000
FaxNumber:  
Practice Location
Address1: 703 MAIN ST
Address2:  
City: PATERSON
State: NJ
PostalCode: 075032621
CountryCode: US
TelephoneNumber: 9737542000
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/21/2011
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2080P0207X25MA10066500NJY Allopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology

No ID Information.


Home