Provider Demographics
NPI:1750466256
Name:WOODHULL MEDICAL & MENTAL HEALTH CENTER
Entity Type:Organization
Organization Name:WOODHULL MEDICAL & MENTAL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ATTENDING ANESTHESIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:HANSA
Authorized Official - Middle Name:ASHOK
Authorized Official - Last Name:DHABUWALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-963-8496
Mailing Address - Street 1:34 CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:GLEN HEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11545-1502
Mailing Address - Country:US
Mailing Address - Phone:516-671-2024
Mailing Address - Fax:
Practice Address - Street 1:760 BROADWAY
Practice Address - Street 2:WOODHULL MEDICAL AND MENTAL HEALTH CTR 3A-30
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-5317
Practice Address - Country:US
Practice Address - Phone:718-963-8496
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY149329282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital