Individual
GENEVIEVE WOOD-MINARDI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
236 BROADWAY, BROOKLYN, NY 11211-6289
(718) 307-1230
Mailing address
107 N OCEAN AVE STE G, PATCHOGUE, NY 11772-2012
(631) 654-5004
(631) 654-5048
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
Primary
024594
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
024594-01
REGISTRATION CERTIFICATE
NY
Enumeration date
08/06/2019
Last updated
04/11/2023
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