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General NPI Number Information
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NPI Number | 1457440372
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Entity Type | Individual
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Provider Name | JOANNE SLOCUM WOODLE MD
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Gender | Female
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2213 INDIAN NECK LN
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City | PECONIC
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State | NY
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Zip | 11958-1723
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Country | US
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Telephone | 631-734-2355
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Fax |
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Provider Business Mailing Address
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Address Line | 2231 INDIAN NECK LANE
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City | PECONIC
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State | NY
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Zip | 11958
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Country | US
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Telephone | 631-734-4066
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 145978
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License Number State | NY
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