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NPI Code Detail

MEDICARE: DR. JUDD GARSON SR. DDS

MEDICARE: DR. JUDD GARSON SR. DDS
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
11223G0001XGeneral Practice Dentistry035589NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1982825691
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JUDD GARSON SR. DDS
Provider Business Mailing Address
First Line : 16 BELAIRE CT
Second Line :
City : OLD BRIDGE
State : NJ
Zip : 08857-3035
Country : US
Telephone Number : 732-607-2223
Fax Number : 732-607-2223
Provider Business Practice Location Address
First Line : 4405 BROADWAY
Second Line :
City : NEW YORK
State : NY
Zip : 10040-4014
Country : US
Telephone Number : 212-568-1500
Fax Number : 212-740-2097
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2007
Last Update Date : 07/08/2007

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