| Doctor Name: | JUDITH M PINE |
| NPI Number: | 1003921198 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 301286 |
| Business Practice Address: | 300 Community Dr Manhasset, NY - 110303816 |
| Business Phone Number: | 5165624330 |
| Business Fax Number: | 5165624332 |
| Mailing Address: | 972 Brush Hollow Rd, 4th Floor WESTBURY |
| State: | NY |
| Postal Code: | 115901740 |
| Phone Number: | 5168765555 |
| Fax Number: | 5168765539 |
| NPI Enumeration Date: | 08/20/2006 |
| NPI Last Update Date: | 08/10/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 301286 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |