Organization
LICH FACULTY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER WOODS DO (GROUP DIRECTOR)
(718) 780-4764
Entity
Organization
Contact information
Practice address
339 HICKS ST, BROOKLYN, NY 11201-5509
(718) 780-1961
Mailing address
407 AIRPORT EXECUTIVE PARK, NANUET, NY 10954-5288
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
08/15/2007
Last updated
06/18/2008
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