Organization Active NPI

Woodhull Medical & Mental Health Center

  • General Acute Care Hospital
  • Brooklyn, NY
National Provider Identifier
1114096492
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
170664 Issued in NY
Legal business name
WOODHULL MEDICAL & MENTAL HEALTH CENTER
Practice address
760 Broadway
Room #3a-30
Brooklyn, NY 11206-5317
Phone
(718) 963-8496
Fax
(718) 963-8501
NPI assigned
Nov 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Stephan Petranker, MD
Title
Chairman
Phone
(718) 963-8496

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 170664 NY Primary

Addresses

Primary practice location

760 Broadway
Room #3a-30
Brooklyn, NY 11206-5317

Mailing address

53 Church Rd
Airmont, NY 10952-4103
Phone (845) 369-7118

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114096492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 CHURCH RD",
            "city": "AIRMONT",
            "state": "NY",
            "postal_code": "109524103",
            "telephone_number": "845-369-7118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 BROADWAY",
            "address_2": "ROOM #3A-30",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112065317",
            "telephone_number": "718-963-8496",
            "fax_number": "718-963-8501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODHULL MEDICAL & MENTAL HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PETRANKER",
        "authorized_official_first_name": "STEPHAN",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "718-963-8496",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NY",
            "license": "170664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.