Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | ME00001901 | NJ |
NPI | 1033184494 |
---|---|
Provider Name | Judith A. Despirito |
First Address | Newton, NJ 07860-2795 |
Second Address | Newton, NJ 07860-2795 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2006 |
Last Update Date | 08/07/2007 |