Doctor Name: | JUDY A PODZIEWSKI |
NPI Number: | 1043573058 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-C |
License Number: | 337331 |
Business Practice Address: | 161 E Main St Suite 300 Port Jervis, NY - 127712113 |
Business Phone Number: | 8458563284 |
Business Fax Number: | 8458563306 |
Mailing Address: | 161 E Main St, Suite 300 PORT JERVIS |
State: | NY |
Postal Code: | 127712113 |
Phone Number: | 8458563284 |
Fax Number: | 8458563306 |
NPI Enumeration Date: | 06/25/2012 |
NPI Last Update Date: | 06/25/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 337331 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |