| Doctor Name: | JUDITH MARIE PENTEDEMOS |
| NPI Number: | 1245371806 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 201948 |
| Business Practice Address: | 200 Groton Rd Ayer, MA - 014321168 |
| Business Phone Number: | 9787849538 |
| Business Fax Number: | 9787849453 |
| Mailing Address: | 200 Groton Rd, AYER |
| State: | MA |
| Postal Code: | 014321168 |
| Phone Number: | 9787849000 |
| Fax Number: | |
| NPI Enumeration Date: | 02/08/2007 |
| NPI Last Update Date: | 02/02/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WD0400X |
| License Number: | 201948 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Diabetes Educator |
| Taxonomy Definition: | |