Provider Demographics
NPI:1659393841
Name:WOODS, AFRIQIYAH NANA (PT)
Entity Type:Individual
Prefix:
First Name:AFRIQIYAH
Middle Name:NANA
Last Name:WOODS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 SAINT JAMES PL
Mailing Address - Street 2:APT 1A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-1839
Mailing Address - Country:US
Mailing Address - Phone:718-857-0578
Mailing Address - Fax:
Practice Address - Street 1:897 BROADWAY
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-1205
Practice Address - Country:US
Practice Address - Phone:212-673-7878
Practice Address - Fax:212-674-7878
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016510-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ96131Medicare ID - Type Unspecified