Provider Demographics
NPI:1316034291
Name:GIUDICE, JOHN THOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN THOMAS
Middle Name:
Last Name:GIUDICE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2179 BOSTON POST RD
Mailing Address - Street 2:
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538-3612
Mailing Address - Country:US
Mailing Address - Phone:914-630-7777
Mailing Address - Fax:866-808-0857
Practice Address - Street 1:2179 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:LARCHMONT
Practice Address - State:NY
Practice Address - Zip Code:10538-3612
Practice Address - Country:US
Practice Address - Phone:914-630-7777
Practice Address - Fax:866-808-0857
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY8976111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX4U051Medicare UPIN