Provider Demographics
NPI:1386462430
Name:WOODLEY, MONIQUE LOUISA (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:MONIQUE
Middle Name:LOUISA
Last Name:WOODLEY
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 GABRIEL DR
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-5647
Mailing Address - Country:US
Mailing Address - Phone:917-518-1216
Mailing Address - Fax:
Practice Address - Street 1:12 GABRIEL DR
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-5647
Practice Address - Country:US
Practice Address - Phone:917-518-1216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-27
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY466069163WN0002X, 163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care