Provider Demographics
NPI:1134707524
Name:MAFFEI, JODY A (FNP)
Entity type:Individual
Prefix:
First Name:JODY
Middle Name:A
Last Name:MAFFEI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 GUNNING RIVER RD BLDG E
Mailing Address - Street 2:
Mailing Address - City:BARNEGAT
Mailing Address - State:NJ
Mailing Address - Zip Code:08005-1436
Mailing Address - Country:US
Mailing Address - Phone:609-660-8002
Mailing Address - Fax:
Practice Address - Street 1:175 GUNNING RIVER RD BLDG E
Practice Address - Street 2:
Practice Address - City:BARNEGAT
Practice Address - State:NJ
Practice Address - Zip Code:08005-1436
Practice Address - Country:US
Practice Address - Phone:609-660-8002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-29
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01118000363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner