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General NPI Number Information
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NPI Number | 1386529568
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Entity Type | Organization
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Legal Business Name | WILLOWDALE HEALTH LLC
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Dates
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Enumeration Date | 08/07/2025
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 18215 HILLSIDE AVE
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City | JAMAICA
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State | NY
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Zip | 11432-4853
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Country | US
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Telephone | 718-291-8200
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Fax |
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Provider Business Mailing Address
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Address Line | 124 FAIRVIEW AVE
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City | GREAT NECK
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State | NY
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Zip | 11023-1334
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Country | US
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Telephone | 646-770-4508
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | HELEN RYU
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Credential | MD
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Telephone | 646-770-4508
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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