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General NPI Number Information
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NPI Number | 1467979807
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Entity Type | Individual
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Provider Name | CAROLINE WOO PMHNP
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Gender | Female
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Dates
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Enumeration Date | 08/26/2017
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Last Update Date | 11/15/2017
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Provider Practice Location Address
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Address Line | 7559 263RD ST
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City | GLEN OAKS
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State | NY
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Zip | 11004-1150
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Country | US
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Telephone | 718-470-8210
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Fax |
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Provider Business Mailing Address
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Address Line | 75-59 263RD STREET AOPD
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City | GLEN OAKS
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State | NY
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Zip | 11004
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Country | US
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Telephone |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | F402054-1
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License Number State | NY
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