Provider Demographics
NPI:1215232384
Name:DELVALLE-WEBB, JUDITH CATHERINE
Entity type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:CATHERINE
Last Name:DELVALLE-WEBB
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 1:224 NORTH BROADWAY
Mailing Address - Street 2:RT 28 BLDG E1
Mailing Address - City:SALE,
Mailing Address - State:NH
Mailing Address - Zip Code:03079
Mailing Address - Country:US
Mailing Address - Phone:603-458-1908
Mailing Address - Fax:
Practice Address - Street 1:224 N BROADWAY
Practice Address - Street 2:RT 28 BLDG E1
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-2145
Practice Address - Country:US
Practice Address - Phone:603-458-1908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-20
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician