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Organization

WOODSIDE MEDICAL CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DANIEL PARK D.O (PRESIDENT)
(718) 446-6579
Entity
Organization

Contact information

Practice address
6019 ROOSEVELT AVE STE 201, WOODSIDE, NY 11377-3537
(718) 446-6579
(718) 446-1213
Mailing address
6019 ROOSEVELT AVE STE 201, WOODSIDE, NY 11377-3537
(718) 446-6579
(718) 446-1213

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
209387
NY

Other

Enumeration date
10/13/2015
Last updated
12/27/2018
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