Basic Information
Provider Information
NPI: 1679734925
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WOODS
FirstName: KRYSTINA
MiddleName: L
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: PADKOWSKY
OtherFirstName: KRYSTINA
OtherMiddleName: L
OtherNamePrefix: DR.
OtherNameSuffix:  
OtherCredential: M.D.
OtherLastNameType: 1
Mailing Information
Address1: 150 E 42ND ST FL 9
Address2:  
City: NEW YORK
State: NY
PostalCode: 100175699
CountryCode: US
TelephoneNumber: 6466058188
FaxNumber: 2125237410
Practice Location
Address1: 1000 10TH AVE
Address2:  
City: NEW YORK
State: NY
PostalCode: 100191147
CountryCode: US
TelephoneNumber: 6466058188
FaxNumber: 2125237410
Other Information
ProviderEnumerationDate: 06/19/2008
LastUpdateDate: 05/14/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RI0200X25MA09372300NJN Allopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
207RI0200X287251NYY Allopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease

No ID Information.


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