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General NPI Number Information
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NPI Number | 1134483530
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Entity Type | Organization
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Legal Business Name | WOODFIELD MEDICAL OFFICE, P.C.
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Dates
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Enumeration Date | 06/29/2012
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Last Update Date | 06/29/2012
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Provider Practice Location Address
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Address Line | 135 WOODFIELD RD
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City | WEST HEMPSTEAD
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State | NY
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Zip | 11552-2524
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Country | US
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Telephone | 516-481-5277
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Fax | 516-481-5278
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Provider Business Mailing Address
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Address Line | 135 WOODFIELD RD
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City | WEST HEMPSTEAD
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State | NY
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Zip | 11552-2524
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Country | US
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Telephone | 516-481-5277
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Fax | 516-481-5278
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL ROSARIO MENDOLA
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Credential | D.O.
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Telephone | 516-481-5277
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207KA0200X
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Taxonomy Name | Allergy Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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