Provider Demographics
NPI:1457068645
Name:BYGATE, JUDITH PAIGE
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:PAIGE
Last Name:BYGATE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 NEAL GATE ST
Mailing Address - Street 2:
Mailing Address - City:SCITUATE
Mailing Address - State:MA
Mailing Address - Zip Code:02066-4426
Mailing Address - Country:US
Mailing Address - Phone:781-724-6635
Mailing Address - Fax:
Practice Address - Street 1:51 NEAL GATE ST
Practice Address - Street 2:
Practice Address - City:SCITUATE
Practice Address - State:MA
Practice Address - Zip Code:02066-4426
Practice Address - Country:US
Practice Address - Phone:781-724-6635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-28
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA253593103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA253593OtherJUDITH BYGATE