Basic Information
| Provider Information | |||||||||
| NPI: | 1619171311 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WOODHULL MEDICAL CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11591 229TH ST | ||||||||
| Address2: | |||||||||
| City: | CAMBRIA HEIGHTS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 114111419 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | WOODHULL MEDICAL CENTER | ||||||||
| Address2: | 760 BROADWAY | ||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189635915 | ||||||||
| FaxNumber: | 7186303138 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | MOISE | ||||||||
| AuthorizedOfficialFirstName: | PATRICIA | ||||||||
| AuthorizedOfficialMiddleName: | CARMELLE | ||||||||
| AuthorizedOfficialTitleorPosition: | SENIOR SOCIAL WORKER | ||||||||
| AuthorizedOfficialTelephone: | 7189635915 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MISS | ||||||||
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| AuthorizedOfficialCredential: | LMSW | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 064200-1 | NY | Y | Hospitals | General Acute Care Hospital |
No ID Information.