Provider Demographics
NPI:1326140815
Name:HUIZENGA, JUDITH N (MD)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:N
Last Name:HUIZENGA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 RADCLIFFE RD
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:MA
Mailing Address - Zip Code:02493-1024
Mailing Address - Country:US
Mailing Address - Phone:781-237-1353
Mailing Address - Fax:781-237-5766
Practice Address - Street 1:10 RADCLIFFE RD
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:MA
Practice Address - Zip Code:02493-1024
Practice Address - Country:US
Practice Address - Phone:781-237-1353
Practice Address - Fax:781-237-5766
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA289802084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAB51036OtherBLUE SHIELD
MAA008168OtherVALUE OPTION
MA761714OtherTUFTS