Provider Demographics
NPI:1972712263
Name:GREENWOODMEDICALPC
Entity type:Organization
Organization Name:GREENWOODMEDICALPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BABURAO
Authorized Official - Middle Name:
Authorized Official - Last Name:DODDAPANENI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-499-4995
Mailing Address - Street 1:4 UNADILLA PLACE
Mailing Address - Street 2:
Mailing Address - City:GREENLAWN
Mailing Address - State:NY
Mailing Address - Zip Code:11740
Mailing Address - Country:US
Mailing Address - Phone:718-499-4995
Mailing Address - Fax:718-499-4851
Practice Address - Street 1:GREENWOOD MEDICAL
Practice Address - Street 2:666 FIFTH AVE
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215
Practice Address - Country:US
Practice Address - Phone:718-499-4995
Practice Address - Fax:718-499-4851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Not Answered2081H0002XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationHospice and Palliative MedicineGroup - Single Specialty