1558564088 NPI number — WOODHULL HOSPITAL

Table of content: (NPI 1558564088)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558564088 NPI number — WOODHULL HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WOODHULL HOSPITAL
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1558564088
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
43 ORCHARD DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLIFTON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07012-2114
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-777-0923
Provider Business Mailing Address Fax Number:
718-630-3138

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
WOODHULL HOSPITAL
Provider Second Line Business Practice Location Address:
760 BROADWAY
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11206
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-963-8951
Provider Business Practice Location Address Fax Number:
718-630-3138
Provider Enumeration Date:
06/11/2007

Additional Information

Authorized Official

Authorized Official Last Name:
LEITH
Authorized Official First Name:
RANDALL
Authorized Official Middle Name:
BRIAN
Authorized Official Title or Position:
SENIOR SOCIAL WORKER
Authorized Official Telephone Number:
718-963-8951

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  R047828-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com