Provider Demographics
NPI:1568711125
Name:JEFFERS, RUKIYA A
Entity Type:Individual
Prefix:MS
First Name:RUKIYA
Middle Name:A
Last Name:JEFFERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O.BOX 38355
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003
Mailing Address - Country:US
Mailing Address - Phone:917-769-5518
Mailing Address - Fax:
Practice Address - Street 1:97B CLARIDGE AVE
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003
Practice Address - Country:US
Practice Address - Phone:917-769-5518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist