Provider Demographics
NPI:1568078764
Name:JUDKINS, SYDNEY MARIE (ATC, LAT)
Entity Type:Individual
Prefix:MISS
First Name:SYDNEY
Middle Name:MARIE
Last Name:JUDKINS
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 PROSPECT DR
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06615-7539
Mailing Address - Country:US
Mailing Address - Phone:412-736-8537
Mailing Address - Fax:
Practice Address - Street 1:1055 POST RD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-6019
Practice Address - Country:US
Practice Address - Phone:203-255-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-22
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0009902081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine