MEDICARE: DR. STEPHEN R JUDGE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	235099	NY

General Provider Information

NPI Number	:	1497702955
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN R JUDGE M.D.

Provider Business Mailing Address
First Line	:	601 ELMWOOD AVE
Second Line	:	BOX 278980
City	:	ROCHESTER
State	:	NY
Zip	:	14642-0001
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2400 S CLINTON AVE
Second Line	:	BUILDING G
City	:	ROCHESTER
State	:	NY
Zip	:	14618-2668
Country	:	US
Telephone Number	:	585-341-7685
Fax Number	:	585-341-4220

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2006
Last Update Date	:	07/05/2023

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