Healthcare Provider Details

I. General information

NPI: 1710959978
Provider Name (Legal Business Name): BRIAN DANIEL WOODS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 02/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 PORT WASHINGTON BLVD NEW YORK CARDIOVASCULAR ANESTHESIOLOGISTS, P.C.
ROSLYN NY
11576
US

IV. Provider business mailing address

100 PORT WASHINGTON BLVD NEW YORK CARDIOVASCULAR ANESTHESIOLOGISTS, P.C.
ROSLYN NY
11576
US

V. Phone/Fax

Practice location:
  • Phone: 516-627-6624
  • Fax: 516-627-3804
Mailing address:
  • Phone: 516-627-6624
  • Fax: 516-627-3804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number224224
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number250399
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberAFE82649
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number250399
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: