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General NPI Number Information
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NPI Number | 1447424049
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Entity Type | Individual
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Provider Name | STACIA ANN WOODCOCK PHARMD
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Gender | Female
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Dates
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Enumeration Date | 04/15/2008
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Last Update Date | 05/28/2020
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Provider Practice Location Address
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Address Line | 10718 70TH RD
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City | FOREST HILLS
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State | NY
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Zip | 11375-4262
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Country | US
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Telephone | 646-968-2872
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Fax |
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Provider Business Mailing Address
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Address Line | 5505 WOODSIDE AVE APT 318
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City | WOODSIDE
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State | NY
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Zip | 11377-3303
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Country | US
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Telephone | 917-902-3471
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH235496
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 049851
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License Number State | NY
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