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Organization
WOODSIDE MEDICAL DIAGNOSTIC, PC.
Active
Organization
WOODSIDE MEDICAL DIAGNOSTIC, PC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ENDORA I. DRAGOMIR (BILLER)
(718) 545-5947
Entity
Organization
Contact information
Practice address
3120 54TH ST, SUITE L2, WOODSIDE, NY 11377-1530
(718) 476-5859
(718) 476-9859
Mailing address
3120 54TH ST, SUITE L2, WOODSIDE, NY 11377-1530
(718) 476-5859
(718) 476-9859
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
178659
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01130987
—
NY
Enumeration date
06/12/2007
Last updated
04/14/2010
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