Active NPI
Woodhull Medical Center
- Physician Assistant
- Brooklyn, NY
National Provider Identifier
1225195043
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 007305
- Legal business name
- WOODHULL MEDICAL CENTER
- Practice address
- 760 Broadway
Brooklyn, NY 11206-5317 - Phone
- (718) 963-8000
- Fax
- (718) 963-5800
- NPI assigned
- Jan 2, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Luis Fernandez, M. D.
- Title
- Radiology Chair
- Phone
- (718) 963-8000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 007305 | NY | Primary |
Addresses
Primary practice location
760 Broadway
Brooklyn, NY 11206-5317
Mailing address
471 Ridge Rd
Campbell Hall, NY 10916-2606
Phone (718) 963-8000
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167696000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1225195043",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "471 RIDGE RD",
"city": "CAMPBELL HALL",
"state": "NY",
"postal_code": "109162606",
"telephone_number": "718-963-8000",
"fax_number": "718-963-5800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "760 BROADWAY",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112065317",
"telephone_number": "718-963-8000",
"fax_number": "718-963-5800"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WOODHULL MEDICAL CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-02",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "FERNANDEZ",
"authorized_official_first_name": "LUIS",
"authorized_official_title_or_position": "RADIOLOGY CHAIR",
"authorized_official_telephone_number": "718-963-8000",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M. D."
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physician Assistant",
"state": "NY",
"license": "007305",
"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.