Provider Demographics
NPI:1861747685
Name:KLEFEKER, MARJORIE GESSNER (NP-C)
Entity type:Individual
Prefix:MS
First Name:MARJORIE
Middle Name:GESSNER
Last Name:KLEFEKER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:MARJORIE
Other - Middle Name:S
Other - Last Name:GESSNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:19 UNION SQ W
Mailing Address - Street 2:7TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-3304
Mailing Address - Country:US
Mailing Address - Phone:212-627-9600
Mailing Address - Fax:212-627-4040
Practice Address - Street 1:680 CENTER ST SIGNATURE HEALTHCARE
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02302
Practice Address - Country:US
Practice Address - Phone:508-941-7000
Practice Address - Fax:508-941-6291
Is Sole Proprietor?:No
Enumeration Date:2012-07-18
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA196575364SW0102X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No364SW0102XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistWomen's Health