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Individual
JUDD JACOB
Active
Individual
JUDD JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, CLS
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
032031
NY
247ZC0005X
Clinical Laboratory Director (Non-physician)
Primary
014999
NY
247ZC0005X
Clinical Laboratory Director (Non-physician)
226448
NULL
Other
Enumeration date
02/10/2011
Last updated
04/13/2016
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