Healthcare Provider Details

I. General information

NPI: 1063671394
Provider Name (Legal Business Name): KRISTEN MICHELE WOODARD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTEN MICHELE POMPIZZI M.D.

II. Dates (important events)

Enumeration Date: 06/02/2008
Last Update Date: 01/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 RYE RIDGE PLZ
RYE BROOK NY
10573-2820
US

IV. Provider business mailing address

26 RYE RIDGE PLZ
RYE BROOK NY
10573-2820
US

V. Phone/Fax

Practice location:
  • Phone: 914-251-1100
  • Fax: 914-251-1109
Mailing address:
  • Phone: 914-251-1100
  • Fax: 914-251-1109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number248778-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: