Provider Demographics
NPI:1356760458
Name:WASILEWSKI, MARIA JOLANTA (RN)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:JOLANTA
Last Name:WASILEWSKI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205-14 LINDEN BLVD,
Mailing Address - Street 2:SUITE 204
Mailing Address - City:QUEENS
Mailing Address - State:NY
Mailing Address - Zip Code:11412-2934
Mailing Address - Country:US
Mailing Address - Phone:718-528-5493
Mailing Address - Fax:718-525-4305
Practice Address - Street 1:205-14 LINDEN BLVD,
Practice Address - Street 2:SUITE 204
Practice Address - City:QUEENS
Practice Address - State:NY
Practice Address - Zip Code:11412-2934
Practice Address - Country:US
Practice Address - Phone:718-528-5493
Practice Address - Fax:718-525-4305
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-16
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY682994163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse