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General NPI Number Information
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NPI Number | 1922046630
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Entity Type | Individual
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Provider Name | JUDITH ANNE LIGHTFOOT D.O.
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Gender | Female
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Dates
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Enumeration Date | 06/03/2006
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Last Update Date | 06/25/2024
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Provider Practice Location Address
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Address Line | 42 E LAUREL RD STE 3100-C
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City | STRATFORD
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State | NJ
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Zip | 08084-1354
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Country | US
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Telephone | 856-566-7070
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Fax | 856-566-6906
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Provider Business Mailing Address
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Address Line | 42 E LAUREL RD STE 3100-C
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City | STRATFORD
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State | NJ
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Zip | 08084-1354
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Country | US
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Telephone | 856-566-7070
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Fax | 856-566-6906
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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 | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | MB66998
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License Number State | NJ
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