Provider Demographics
NPI:1023223906
Name:JUDY ANDERSON, MD, PC
Entity Type:Organization
Organization Name:JUDY ANDERSON, MD, PC
Other - Org Name:VISITING PHYSICIANS OF THE DELAWARE VALLEY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:MILLSPAUGH
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-634-8412
Mailing Address - Street 1:1829 BUSTLETON PIKE
Mailing Address - Street 2:
Mailing Address - City:FEASTERVILLE TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-7309
Mailing Address - Country:US
Mailing Address - Phone:215-364-8412
Mailing Address - Fax:215-364-8730
Practice Address - Street 1:1829 BUSTLETON PIKE
Practice Address - Street 2:
Practice Address - City:FEASTERVILLE TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-7309
Practice Address - Country:US
Practice Address - Phone:215-364-8412
Practice Address - Fax:215-364-8730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA047067Medicare ID - Type UnspecifiedPROVIDER NUMBER