Healthcare Provider Details

I. General information

NPI: 1033184494
Provider Name (Legal Business Name): JUDITH A. DESPIRITO
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 NEWTON SPARTA RD
NEWTON NJ
07860-2795
US

IV. Provider business mailing address

135 NEWTON SPARTA RD
NEWTON NJ
07860-2795
US

V. Phone/Fax

Practice location:
  • Phone: 973-383-6738
  • Fax: 973-383-8034
Mailing address:
  • Phone: 973-383-6738
  • Fax: 973-383-8034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberME00001901
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: