=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982652848
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HENRY H WOO MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/04/2006
-----------------------------------------------------
Last Update Date | 07/23/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 101 NICOLLS RD CV CENTER, HOSP LEVEL 4, RM 430
-----------------------------------------------------
City | STONY BROOK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11794-7447
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 631-444-9137
-----------------------------------------------------
Fax | 631-444-1535
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | DEPT OF NEUROLOGICAL SURGERY HSC T-12, RM 080
-----------------------------------------------------
City | STONY BROOK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11794-8122
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 631-444-9137
-----------------------------------------------------
Fax | 631-444-6230
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207T00000X
-----------------------------------------------------
Taxonomy Name | Neurological Surgery Physician
-----------------------------------------------------
License Number | 208357
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------