Provider Demographics
NPI:1700156080
Name:STOFFEL, JUDY
Entity Type:Individual
Prefix:MRS
First Name:JUDY
Middle Name:
Last Name:STOFFEL
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 1:35 MADISON AVENUE
Mailing Address - Street 2:P.O. BOX 673
Mailing Address - City:ANTWERP
Mailing Address - State:NY
Mailing Address - Zip Code:13608
Mailing Address - Country:US
Mailing Address - Phone:315-659-8401
Mailing Address - Fax:
Practice Address - Street 1:8442 S MAIN ST
Practice Address - Street 2:
Practice Address - City:EVANS MILLS
Practice Address - State:NY
Practice Address - Zip Code:13637-3201
Practice Address - Country:US
Practice Address - Phone:315-629-4331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-04
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY305177-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool