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Individual

MS. JUDITH ANNE MALONEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ANP

Contact information

Practice address
228 SHERMAN ST, WATERTOWN, NY 13601-3612
(315) 788-9849
Mailing address
228 SHERMAN ST, WATERTOWN, NY 13601-3615
(315) 788-9849

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F303285
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
F303285
LICENSE
NY
Enumeration date
11/09/2005
Last updated
05/28/2008
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