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General NPI Number Information
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NPI Number | 1942358106
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Entity Type | Individual
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Provider Name | JUDITH SHARON BESSOFF ANP-C
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Gender | Female
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Dates
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Enumeration Date | 01/06/2007
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Last Update Date | 05/27/2014
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Provider Practice Location Address
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Address Line | 475 KILVERT ST
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City | WARWICK
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State | RI
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Zip | 02886-1379
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Country | US
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Telephone | 401-714-6094
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Fax |
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Provider Business Mailing Address
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Address Line | 116 BLAISDELL AVE
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City | PAWTUCKET
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State | RI
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Zip | 02860-5751
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Country | US
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Telephone | 401-465-0346
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | NPP30348
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License Number State | RI
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