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Judy Tack
NPI 1962712430 · on the registry since 2010 · sole proprietor
Practice
- Address
- 222 Deerwood Dr
Baldwinsville, NY 13027 - Phone
- (315) 638-6126
- Clinicians at this address
- 3
Registry record
- Primary taxonomy
- 163W00000X
163W00000X
- Licence states on file
- NY
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2010-10-18
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New York