Provider Demographics
NPI:1649321381
Name:WOODS, PETER ALBERT JR (DO)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:ALBERT
Last Name:WOODS
Suffix:JR
Gender:M
Credentials:DO
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Mailing Address - Street 1:160 WATER ST
Mailing Address - Street 2:23RD FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-4922
Mailing Address - Country:US
Mailing Address - Phone:212-256-3539
Mailing Address - Fax:212-256-3632
Practice Address - Street 1:339 HICKS ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5509
Practice Address - Country:US
Practice Address - Phone:718-780-4764
Practice Address - Fax:718-780-1313
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2011-08-23
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Provider Licenses
StateLicense IDTaxonomies
NY212481207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01906312Medicaid
NYG91848Medicare UPIN
NY01906312Medicaid