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NPI Code Detail

MEDICARE: RICHARD WOODHOUSE PH.D.

MEDICARE: RICHARD WOODHOUSE PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist006480NY

General Provider Information

NPI Number : 1669422176
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD WOODHOUSE PH.D.
Provider Business Mailing Address
First Line : 303 MERRICK RD
Second Line : SUITE 204
City : LYNBROOK
State : NY
Zip : 11563-2501
Country : US
Telephone Number : 800-725-6280
Fax Number : 800-725-6380
Provider Business Practice Location Address
First Line : 2 EXECUTIVE PARK DR
Second Line :
City : ALBANY
State : NY
Zip : 12203-3700
Country : US
Telephone Number : 518-438-2373
Fax Number : 518-438-4371
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2006
Last Update Date : 10/11/2011

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