Individual
JUDY JICINSKY
Active
Individual
JUDY JICINSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
02851
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0429027
—
IA
01
—
30406
WELLMARK BCBS
IA
01
—
F232553
MIDLANDS CHOICE
IA
01
—
P00062328
RAILROAD MEDICARE
IA
Enumeration date
07/31/2006
Last updated
07/08/2007
Update your record
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