Provider Demographics
NPI:1063671394
Name:WOODARD, KRISTEN MICHELE (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:MICHELE
Last Name:WOODARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KRISTEN
Other - Middle Name:MICHELE
Other - Last Name:POMPIZZI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:26 RYE RIDGE PLZ
Mailing Address - Street 2:
Mailing Address - City:RYE BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:10573-2820
Mailing Address - Country:US
Mailing Address - Phone:914-251-1100
Mailing Address - Fax:914-251-1109
Practice Address - Street 1:26 RYE RIDGE PLZ
Practice Address - Street 2:
Practice Address - City:RYE BROOK
Practice Address - State:NY
Practice Address - Zip Code:10573-2820
Practice Address - Country:US
Practice Address - Phone:914-251-1100
Practice Address - Fax:914-251-1109
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY248778-1208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics