Physician Compare National (NPI:1891868253)

HEALTHCARE PROVIDER: JUDY LYNN BLUMENFELD PHD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1891868253
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7911168414
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120410000368
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BLUMENFELD
	Individual professional last name
Provider First Name	JUDY
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1977
	Individual professional's medical school graduation year
Primary Specialty	PSYCHOLOGIST, CLINICAL
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	10303 N PORT WASHINGTON RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 203
	Group Practice or individual's line 2 address
City	MEQUON
	Group Practice or individual's city
State	WI
	Group Practice or individual's state
Zip Code	530925760
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y