Provider Demographics
NPI:1649578634
Name:BUFFA, JUDY M (SLP)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:M
Last Name:BUFFA
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 DORA DR
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:NY
Mailing Address - Zip Code:12701-4111
Mailing Address - Country:US
Mailing Address - Phone:845-796-2777
Mailing Address - Fax:845-794-2234
Practice Address - Street 1:24 DORA DR
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:NY
Practice Address - Zip Code:12701-4111
Practice Address - Country:US
Practice Address - Phone:845-796-2777
Practice Address - Fax:845-794-2234
Is Sole Proprietor?:No
Enumeration Date:2011-03-01
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005799235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist