Provider Demographics
NPI:1053376657
Name:WOODS, KATHLEEN (NP)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:
Last Name:WOODS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 CRONISER DR
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL
Mailing Address - State:NY
Mailing Address - Zip Code:12533-6156
Mailing Address - Country:US
Mailing Address - Phone:212-686-7500
Mailing Address - Fax:212-951-6847
Practice Address - Street 1:423 E 23RD ST
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:NY
Practice Address - Zip Code:10010-5011
Practice Address - Country:US
Practice Address - Phone:212-686-7500
Practice Address - Fax:212-951-6847
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF302904363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health