Individual
MARY ELLEN JUDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
679 KIDDER ST, WILKES BARRE, PA 18702-6908
(570) 825-3491
Mailing address
500 SCOTT ST, WILKES BARRE, PA 18702-5613
(570) 704-0300
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OE006896T
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0070462900002
—
PA
Enumeration date
09/01/2005
Last updated
12/01/2022
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