Healthcare Provider Details

I. General information

NPI: 1831178847
Provider Name (Legal Business Name): ERICKA C WOODS PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2006
Last Update Date: 07/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BROOKDALE UNIVERSITY AND MEDICAL CENTER 1 BROOKDALE PLAZA - PSYCHIATRY DEPT. - 12TH FLOOR
BROOKLYN NY
11212
US

IV. Provider business mailing address

353 HINSDALE ST
BROOKLYN NY
11207-4504
US

V. Phone/Fax

Practice location:
  • Phone: 718-240-5645
  • Fax:
Mailing address:
  • Phone: 718-495-3787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number0153901
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: