Provider Demographics
NPI:1295392934
Name:ALMONTE, MADELYN JUDDI
Entity Type:Individual
Prefix:
First Name:MADELYN
Middle Name:JUDDI
Last Name:ALMONTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 GORDON ST APT 8E
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-1934
Mailing Address - Country:US
Mailing Address - Phone:347-863-8888
Mailing Address - Fax:
Practice Address - Street 1:181 GORDON ST APT 8E
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-1934
Practice Address - Country:US
Practice Address - Phone:347-863-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-28
Last Update Date:2019-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00846180374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYSR34135YMedicaid