# WOODSIDE MEDICAL REHABILITATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578698908
- **Authorized official:** MR. JAE O PARK MD (MD)
- **Authorized official phone:** (718) 986-5841

## Contact information

- **Practice address:** 14370 SANFORD AVE, FLUSHING, NY 11355-2044
- **Practice address phone:** (718) 886-6268
- **Mailing address:** 14370 SANFORD AVE, FLUSHING, NY 11355-2044
- **Mailing address phone:** (718) 886-6268

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | 130080-1 | NY | Yes |

## Other

- **Enumeration date:** 02/23/2007
- **Last updated:** 08/22/2020