Provider Demographics
NPI:1669259206
Name:LUDLOW, JOSEPH (BS)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:LUDLOW
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 MEMORIAL DR APT 1405
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-4903
Mailing Address - Country:US
Mailing Address - Phone:801-472-7235
Mailing Address - Fax:
Practice Address - Street 1:2990 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02119-1203
Practice Address - Country:US
Practice Address - Phone:781-296-9875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-08
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker