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NPI Code Detail

MEDICARE: JUDITH L GORELICK MD

MEDICARE:   JUDITH L GORELICK  MD
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
1207T00000XNeurological Surgery Physician039473CT

General Provider Information

NPI Number : 1417962093
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUDITH L GORELICK MD
Provider Business Mailing Address
First Line : 330 BRIDGEPORT AVE
Second Line :
City : SHELTON
State : CT
Zip : 06484-3861
Country : US
Telephone Number : 203-755-6677
Fax Number : 203-755-7166
Provider Business Practice Location Address
First Line : 330 BRIDGEPORT AVE
Second Line :
City : SHELTON
State : CT
Zip : 06484-3861
Country : US
Telephone Number : 203-755-6677
Fax Number : 203-755-7166
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2006
Last Update Date : 01/24/2017

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Directions to “ JUDITH L GORELICK MD” Practice Location

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