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General NPI Number Information
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NPI Number | 1629146113
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Entity Type | Organization
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Legal Business Name | JUDY R. ANDERSON,M.D.,P.C.
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 09/19/2007
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Provider Practice Location Address
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Address Line | 984 N BROADWAY STE 310
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City | YONKERS
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State | NY
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Zip | 10701-1318
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Country | US
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Telephone | 914-963-0010
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Fax | 914-963-8406
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Provider Business Mailing Address
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Address Line | 984 N BROADWAY STE 310
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City | YONKERS
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State | NY
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Zip | 10701-1318
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Country | US
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Telephone | 914-963-0010
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Fax | 914-963-8406
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. JUDY R ANDERSON
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Credential | MD
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Telephone | 914-963-0010
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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 | 202419
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License Number State | NY
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