Provider Demographics
NPI:1477963114
Name:HUFNAGEL, JUDITH (RD)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:HUFNAGEL
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW EAGLE
Mailing Address - State:PA
Mailing Address - Zip Code:15067-1502
Mailing Address - Country:US
Mailing Address - Phone:724-249-3208
Mailing Address - Fax:
Practice Address - Street 1:114 4TH AVE
Practice Address - Street 2:
Practice Address - City:NEW EAGLE
Practice Address - State:PA
Practice Address - Zip Code:15067-1502
Practice Address - Country:US
Practice Address - Phone:724-249-3208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-03
Last Update Date:2014-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN004642133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered