Provider Demographics
NPI:1326125303
Name:WOOD HULL MEDICAL&MENTAL HEALTH CTR
Entity Type:Organization
Organization Name:WOOD HULL MEDICAL&MENTAL HEALTH CTR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ATTENDING
Authorized Official - Prefix:DR
Authorized Official - First Name:SREEDHAR
Authorized Official - Middle Name:
Authorized Official - Last Name:KOMMINENI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-963-8496
Mailing Address - Street 1:6833 SHORE RD APT 5A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-5059
Mailing Address - Country:US
Mailing Address - Phone:718-491-2996
Mailing Address - Fax:
Practice Address - Street 1:720 FLUSHING AVE
Practice Address - Street 2:WOODHULL MEDICAL & MENTAL HEALTH CENTER
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206
Practice Address - Country:US
Practice Address - Phone:718-963-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY232312281P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes281P00000XHospitalsChronic Disease Hospital