| NPI | 1801945738 |
|---|---|
| Other Name | WOODSIDE CLINIC |
| Entity Type | Organization |
| Authorized Contact | JEAN M COPPOLA Director Of Billing 718-651-7770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2013-12-19 |