MEDICARE: MRS. JUDITH ARTESSA PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	002604-1	NY

General Provider Information

NPI Number	:	1033518717
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JUDITH ARTESSA PT

Provider Business Mailing Address
First Line	:	4715 E LAKE RD
Second Line	:
City	:	HAMILTON
State	:	NY
Zip	:	13346-3521
Country	:	US
Telephone Number	:	315-824-1372
Fax Number	:

Provider Business Practice Location Address
First Line	:	4715 E LAKE RD
Second Line	:
City	:	HAMILTON
State	:	NY
Zip	:	13346-3521
Country	:	US
Telephone Number	:	315-824-1372
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2014
Last Update Date	:	08/19/2014

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Directions to “ MRS. JUDITH ARTESSA PT” Practice Location

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