Provider Demographics
NPI:1922362524
Name:BECKETT WOODS, RENEE L (MS)
Entity Type:Individual
Prefix:MISS
First Name:RENEE
Middle Name:L
Last Name:BECKETT WOODS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4181 LACONIA AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10466-4912
Mailing Address - Country:US
Mailing Address - Phone:347-821-1651
Mailing Address - Fax:
Practice Address - Street 1:4181 LACONIA AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466-4912
Practice Address - Country:US
Practice Address - Phone:347-821-1651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-27
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist