Provider Demographics
NPI:1124059068
Name:RICHARD M. WOOD, MD, P.C.
Entity type:Organization
Organization Name:RICHARD M. WOOD, MD, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:M
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-821-5484
Mailing Address - Street 1:2 PROSPECT HILL RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON CORNERS
Mailing Address - State:NY
Mailing Address - Zip Code:12514-2449
Mailing Address - Country:US
Mailing Address - Phone:518-821-5484
Mailing Address - Fax:845-546-3403
Practice Address - Street 1:555 UNION ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-2815
Practice Address - Country:US
Practice Address - Phone:518-821-5484
Practice Address - Fax:518-546-3403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2210941207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRW0482E110Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER