Individual
JUDD JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, CLS
Contact information
Practice address
340 S BROADWAY, YONKERS, NY 10705-2049
(914) 968-5125
(914) 968-5123
Mailing address
174 GRAND ST, WHITE PLAINS, NY 10601-4803
(914) 328-8077
(914) 328-6083
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
—
Other
Enumeration date
02/10/2011
Last updated
04/13/2016
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