Healthcare Provider Details

I. General information

NPI: 1972712263
Provider Name (Legal Business Name): GREENWOODMEDICALPC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

GREENWOOD MEDICAL 666 FIFTH AVE
BROOKLYN NY
11215
US

IV. Provider business mailing address

4 UNADILLA PLACE
GREENLAWN NY
11740
US

V. Phone/Fax

Practice location:
  • Phone: 718-499-4995
  • Fax: 718-499-4851
Mailing address:
  • Phone: 718-499-4995
  • Fax: 718-499-4851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2081H0002X
TaxonomyHospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: BABURAO DODDAPANENI
Title or Position: PRESIDENT
Credential: MD
Phone: 718-499-4995