MEDICARE: MARIA JEFFERS-WOODLEY

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
1	163W00000X	Registered Nurse	58457	NY

General Provider Information

NPI Number	:	1447871041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA JEFFERS-WOODLEY

Provider Business Mailing Address
First Line	:	4011 CLARENDON RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11203-5134
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4011 CLARENDON RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11203-5134
Country	:	US
Telephone Number	:	646-247-2002
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2020
Last Update Date	:	05/05/2020

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Directions to “ MARIA JEFFERS-WOODLEY ” Practice Location

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