Basic Information
Provider Information
NPI: 1841493335
EntityType: 2
ReplacementNPI:  
OrganizationName: WOODHULL HOSPITAL
LastName:  
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MiddleName:  
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Credential:  
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Mailing Information
Address1: 233A WYCKOFF ST
Address2:  
City: BROOKLYN
State: NY
PostalCode: 112172208
CountryCode: US
TelephoneNumber: 7184516966
FaxNumber: 7186303138
Practice Location
Address1: WOODHULL HOSPITAL
Address2: 760 BROADWAY
City: BROOKLYN
State: NY
PostalCode: 11206
CountryCode: US
TelephoneNumber: 7189638602
FaxNumber: 7186303138
Other Information
ProviderEnumerationDate: 06/11/2007
LastUpdateDate: 08/22/2020
NPIDeactivationReasonCode:  
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ProviderGenderCode:  
AuthorizedOfficialLastName: TYLER
AuthorizedOfficialFirstName: SARA
AuthorizedOfficialMiddleName: CHEEVER
AuthorizedOfficialTitleorPosition: SOCIAL WORKER
AuthorizedOfficialTelephone: 7189638602
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MS.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: LMSW
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
282N00000X073660NYY HospitalsGeneral Acute Care Hospital 

No ID Information.


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