Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 172241 | NY |
N | 111NI0900X | Internist | 172241 | NY |
Y | 207RA0401X | Internist - Addiction Medicine | 172241 | NY |
NPI | 1245452374 |
---|---|
Provider Name | Dr. Judith Ann Branche |
First Address | Cornwall, NY 12518-1323 |
Second Address | Newburgh, NY 12550-5306 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2007 |
Last Update Date | 19/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01104654 | (05) | NY |