Organization Active NPI

Woodside Medical Rebabilitation, PC

  • Physical Medicine & Rehabilitation Physician
  • Flushing, NY
National Provider Identifier
1841490836
Registry record updated Jul 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
WOODSIDE MEDICAL REBABILITATION, PC
Practice address
14370 Sanford Ave
Flushing, NY 11355-2044
Phone
(718) 986-5841
NPI assigned
Jul 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2007

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

Authorized official

Name
Miss Eunyung Kwon
Title
Biller
Phone
(718) 986-5841

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

14370 Sanford Ave
Flushing, NY 11355-2044

Mailing address

PO Box 540975
Flushing, NY 11354-0975

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1184803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184803200000",
    "number": "1841490836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 540975",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113540975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14370 SANFORD AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113552044",
            "telephone_number": "718-986-5841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODSIDE MEDICAL REBABILITATION, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-19",
        "last_updated": "2007-07-19",
        "status": "A",
        "authorized_official_last_name": "KWON",
        "authorized_official_first_name": "EUNYUNG",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "718-986-5841",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2007; 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.