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General NPI Number Information
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NPI Number | 1770308553
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Entity Type | Individual
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Provider Name | JESSICA MARIE WOODS
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Gender | Female
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Dates
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Enumeration Date | 11/18/2024
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Last Update Date | 12/12/2024
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Provider Practice Location Address
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Address Line | 500 BI COUNTY BLVD STE 300
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City | FARMINGDALE
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State | NY
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Zip | 11735-3931
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Country | US
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Telephone | 516-393-8330
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Fax |
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Provider Business Mailing Address
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Address Line | 222 N OAK ST
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City | MASSAPEQUA
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State | NY
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Zip | 11758-3124
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Country | US
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Telephone | 516-557-4223
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 029677-01
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License Number State | NY
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