Provider Demographics
NPI:1326301326
Name:SIGALL, JUDITH (MS)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:
Last Name:SIGALL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MISS
Other - First Name:JUDITH
Other - Middle Name:
Other - Last Name:GELLMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:6740 BOOTH ST
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-2755
Mailing Address - Country:US
Mailing Address - Phone:917-667-5951
Mailing Address - Fax:
Practice Address - Street 1:6740 BOOTH ST
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-2755
Practice Address - Country:US
Practice Address - Phone:917-667-5951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-25
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY498768931174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist