Provider Demographics
NPI:1740609619
Name:POCHOBRADSKY, JUDITH (LMT)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:POCHOBRADSKY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 TROY RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:EAST GREENBUSH
Mailing Address - State:NY
Mailing Address - Zip Code:12061-1330
Mailing Address - Country:US
Mailing Address - Phone:518-487-4148
Mailing Address - Fax:
Practice Address - Street 1:77 TROY RD
Practice Address - Street 2:SUITE E
Practice Address - City:EAST GREENBUSH
Practice Address - State:NY
Practice Address - Zip Code:12061-1330
Practice Address - Country:US
Practice Address - Phone:518-487-4148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-08
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017433225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist