Healthcare Provider Details

I. General information

NPI: 1255698502
Provider Name (Legal Business Name): JUDITH A ORLANDO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2012
Last Update Date: 04/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6125 MARATHON PKWY
LITTLE NECK NY
11362-2042
US

IV. Provider business mailing address

519 115TH ST
COLLEGE POINT NY
11356-1021
US

V. Phone/Fax

Practice location:
  • Phone: 718-224-8060
  • Fax: 718-224-5914
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number412840/1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: