Provider Demographics
NPI:1295195212
Name:JUDICE, ANTHONY DOMINIC JR (DO)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:DOMINIC
Last Name:JUDICE
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2410 RIDGEWAY AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-4114
Mailing Address - Country:US
Mailing Address - Phone:585-723-3000
Mailing Address - Fax:
Practice Address - Street 1:2410 RIDGEWAY AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-4114
Practice Address - Country:US
Practice Address - Phone:585-723-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-03
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY318997207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery