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General NPI Number Information
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NPI Number | 1114902855
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Entity Type | Individual
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Provider Name | JUDITH HANDJINICOLAOU
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Gender | Female
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Dates
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Enumeration Date | 12/14/2005
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Last Update Date | 05/28/2009
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Provider Practice Location Address
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Address Line | 3301 NEW MEXICO AVE NW SUITE 210
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City | WASHINGTON
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State | DC
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Zip | 20016-3622
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Country | US
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Telephone | 202-363-9600
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Fax | 202-363-9601
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Provider Business Mailing Address
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Address Line | 3301 NEW MEXICO AVE NW SUITE 210
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City | WASHINGTON
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State | DC
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Zip | 20016-3622
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Country | US
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Telephone | 202-363-9600
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Fax | 202-363-9601
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | RN966229
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN9662299
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024166703
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License Number State | VA
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