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General NPI Number Information
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NPI Number | 1063305035
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Entity Type | Individual
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Provider Name | JUDITHO ELMA GADINGAN LPN
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Gender | Male
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Dates
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Enumeration Date | 05/30/2025
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 4238 MERRICK RD
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City | MASSAPEQUA
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State | NY
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Zip | 11758-6016
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Country | US
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Telephone | 516-900-1977
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Fax | 516-900-1978
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Provider Business Mailing Address
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Address Line | 7410 BOULEVARD E APT 2B
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City | NORTH BERGEN
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State | NJ
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Zip | 07047-7903
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Country | US
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Telephone | 344-729-3942
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 305098-1
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License Number State | NY
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