Individual
JUDITH WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
80TH STREET & 41ST AVENUE, ELMHURST, NY 11373
(718) 334-5970
(718) 334-5958
Mailing address
7901 BROADWAY, MANAGED CARE D-1-4, ELMHURST, NY 11373-1329
(718) 334-1920
(718) 334-3432
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F303373
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02904910
—
NY
Enumeration date
05/03/2007
Last updated
02/11/2015
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