Provider Demographics
NPI:1376689448
Name:CHALEFF, JUDITH AMY (LAC)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:AMY
Last Name:CHALEFF
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:MS
Other - First Name:JUDY
Other - Middle Name:
Other - Last Name:CHALEFF
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN LAC
Mailing Address - Street 1:260 CARTER AVE
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-1225
Mailing Address - Country:US
Mailing Address - Phone:845-569-8119
Mailing Address - Fax:
Practice Address - Street 1:275 NORTH ST
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-3143
Practice Address - Country:US
Practice Address - Phone:914-309-2099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001918171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist