Provider Demographics
NPI:1427388891
Name:BIRCH, JUDITH MINOTT (RN)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:MINOTT
Last Name:BIRCH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2021 GRAND CONCOURSE
Mailing Address - Street 2:RM 809
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10453-4304
Mailing Address - Country:US
Mailing Address - Phone:718-960-3080
Mailing Address - Fax:718-583-4080
Practice Address - Street 1:2021 GRAND CONCOURSE
Practice Address - Street 2:RM 809
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-4304
Practice Address - Country:US
Practice Address - Phone:718-960-3080
Practice Address - Fax:718-583-4080
Is Sole Proprietor?:No
Enumeration Date:2010-01-07
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY262872-1163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health