Provider Demographics
NPI:1285936344
Name:KLEIN, JUDITH ALMA (RN)
Entity type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:ALMA
Last Name:KLEIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:JUDITH
Other - Middle Name:ALMA
Other - Last Name:KLEIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:2089 MAIDEN LN
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-1246
Mailing Address - Country:US
Mailing Address - Phone:585-966-4705
Mailing Address - Fax:585-699-4778
Practice Address - Street 1:2089 MAIDEN LN
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-1246
Practice Address - Country:US
Practice Address - Phone:585-966-4705
Practice Address - Fax:585-699-4778
Is Sole Proprietor?:No
Enumeration Date:2010-11-23
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY248944-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse