Provider Demographics
NPI:1437431905
Name:SPICA, JUDY VU (PHARMD)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:VU
Last Name:SPICA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 BALTIMORE PIKE
Mailing Address - Street 2:WALGREENS
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342-9442
Mailing Address - Country:US
Mailing Address - Phone:610-358-9725
Mailing Address - Fax:
Practice Address - Street 1:51 BALTIMORE PIKE
Practice Address - Street 2:WALGREENS
Practice Address - City:GLEN MILLS
Practice Address - State:PA
Practice Address - Zip Code:19342-9442
Practice Address - Country:US
Practice Address - Phone:610-358-9725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-12
Last Update Date:2015-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0004082183500000X
PARP445106183500000X
NJ28RI03424100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist