Provider Demographics
NPI:1417922451
Name:JUDD, BARRY L
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:L
Last Name:JUDD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 N NEVILLE ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-2853
Mailing Address - Country:US
Mailing Address - Phone:412-687-6874
Mailing Address - Fax:412-682-5650
Practice Address - Street 1:540 N NEVILLE ST
Practice Address - Street 2:SUITE 102
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2853
Practice Address - Country:US
Practice Address - Phone:412-687-6874
Practice Address - Fax:412-682-5650
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD031680E2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA410790Medicare ID - Type UnspecifiedMEDICARE
PAB41350Medicare UPIN