Provider Demographics
NPI:1558564088
Name:WOODHULL HOSPITAL
Entity Type:Organization
Organization Name:WOODHULL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR SOCIAL WORKER
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:LEITH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:718-963-8951
Mailing Address - Street 1:43 ORCHARD DR
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07012-2114
Mailing Address - Country:US
Mailing Address - Phone:973-777-0923
Mailing Address - Fax:718-630-3138
Practice Address - Street 1:WOODHULL HOSPITAL
Practice Address - Street 2:760 BROADWAY
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206
Practice Address - Country:US
Practice Address - Phone:718-963-8951
Practice Address - Fax:718-630-3138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR047828-1282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY018499Medicare ID - Type Unspecified