Provider Demographics
NPI:1760649875
Name:LAJUDICE, THOMAS EUGENE (CNP)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:EUGENE
Last Name:LAJUDICE
Suffix:
Gender:M
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 NORTHBEND CT
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-2122
Mailing Address - Country:US
Mailing Address - Phone:302-456-1577
Mailing Address - Fax:
Practice Address - Street 1:106 BOW ST
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-5544
Practice Address - Country:US
Practice Address - Phone:443-907-3592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELB-0000168363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health