MEDICARE: DR. JUDITH CARNEY

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	103T00000X	Psychologist

General Provider Information

NPI Number	:	1659785947
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUDITH CARNEY

Provider Business Mailing Address
First Line	:	4716 PALMBROOKE CIR
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33417-7533
Country	:	US
Telephone Number	:	561-577-2352
Fax Number	:

Provider Business Practice Location Address
First Line	:	4716 PALMBROOKE CIR
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33417-7533
Country	:	US
Telephone Number	:	908-328-5051
Fax Number	:

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

Provider Enumeration Date	:	06/16/2014
Last Update Date	:	11/28/2016

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