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Organization
WOODBINE MEDICAL PC
Active
Organization
WOODBINE MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID CARMILI (DIRECTOR OFFICER)
(718) 418-5320
Entity
Organization
Contact information
Practice address
714 SENECA AVE, RIDGEWOOD, NY 11385-2895
(718) 418-5320
Mailing address
714 SENECA AVE, RIDGEWOOD, NY 11385-2895
(718) 418-5320
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
022692
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02632117
—
NY
Enumeration date
12/12/2006
Last updated
08/22/2020
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