Provider Demographics
NPI:1659418978
Name:JAPA CAMILO, JUDELKA (MD)
Entity Type:Individual
Prefix:MRS
First Name:JUDELKA
Middle Name:
Last Name:JAPA CAMILO
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 1:80 PASSAIC AVENUE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055
Mailing Address - Country:US
Mailing Address - Phone:973-471-1010
Mailing Address - Fax:973-471-5961
Practice Address - Street 1:80 PASSAIC AVENUE
Practice Address - Street 2:SUITE 2
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055
Practice Address - Country:US
Practice Address - Phone:973-471-1010
Practice Address - Fax:973-471-5961
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08000400208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJD08812900OtherCDS
NJD08812900OtherCDS