Individual
JUSTINE L WALDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
101 DATES DR, ITHACA, NY 14850-1342
(607) 274-4150
(607) 274-4132
Mailing address
101 DATES DR, ITHACA, NY 14850-1342
(607) 274-4150
(607) 274-4132
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
225677
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00220092
ABEM
—
05
—
02298626
—
NY
01
—
225677
STATE LICENSE
NY
01
—
A70878
STATE LICENSE
CA
Enumeration date
09/25/2006
Last updated
03/07/2023
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