Provider Demographics
NPI:1134483530
Name:WOODFIELD MEDICAL OFFICE, P.C.
Entity Type:Organization
Organization Name:WOODFIELD MEDICAL OFFICE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ROSARIO
Authorized Official - Last Name:MENDOLA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:516-481-5277
Mailing Address - Street 1:135 WOODFIELD RD
Mailing Address - Street 2:
Mailing Address - City:WEST HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11552-2524
Mailing Address - Country:US
Mailing Address - Phone:516-481-5277
Mailing Address - Fax:516-481-5278
Practice Address - Street 1:135 WOODFIELD RD
Practice Address - Street 2:
Practice Address - City:WEST HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11552-2524
Practice Address - Country:US
Practice Address - Phone:516-481-5277
Practice Address - Fax:516-481-5278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-29
Last Update Date:2012-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty
No207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Multi-Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty