Provider Demographics
NPI:1568477214
Name:JOY-PARDI, JUDY ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:JUDY
Middle Name:ANN
Last Name:JOY-PARDI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:831 MAPLE RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-3267
Mailing Address - Country:US
Mailing Address - Phone:716-565-1978
Mailing Address - Fax:716-565-1983
Practice Address - Street 1:831 MAPLE RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-3267
Practice Address - Country:US
Practice Address - Phone:716-565-1978
Practice Address - Fax:716-565-1983
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-30
Last Update Date:2014-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY183358207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01560663Medicaid
NYG11496Medicare PIN