Organization
WOODSIDE MEDICAL SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SERBAN I COCIOBA M.D. (PRESIDENT)
(718) 476-5859
Entity
Organization
Contact information
Practice address
31-20 54TH STREET, SUITE L2, WOODSIDE, NY 11377-1530
(718) 476-5859
Mailing address
3120 54TH ST, SUITE L2, WOODSIDE, NY 11377-1530
(718) 476-5859
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A30026029
—
NY
Enumeration date
08/19/2011
Last updated
08/19/2011
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