Provider Demographics
NPI:1770673642
Name:GAUTIER-SCIPIONE, JUDITH (PA)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:GAUTIER-SCIPIONE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2463 LODOVICK AVE PH
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-6247
Mailing Address - Country:US
Mailing Address - Phone:718-862-4228
Mailing Address - Fax:
Practice Address - Street 1:1825 EASTCHESTER ROAD
Practice Address - Street 2:MONTEFIORE HOSPITAL
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461
Practice Address - Country:US
Practice Address - Phone:718-904-2400
Practice Address - Fax:718-904-2827
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2015-07-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY002808363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant