Provider Demographics
NPI:1396229753
Name:WINSLOW, JUDITH ANNE
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:ANNE
Last Name:WINSLOW
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 1:18 S PARK PL
Mailing Address - Street 2:
Mailing Address - City:LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01106-1133
Mailing Address - Country:US
Mailing Address - Phone:508-284-2444
Mailing Address - Fax:
Practice Address - Street 1:18 S PARK PL
Practice Address - Street 2:
Practice Address - City:LONGMEADOW
Practice Address - State:MA
Practice Address - Zip Code:01106-1133
Practice Address - Country:US
Practice Address - Phone:508-284-2444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-21
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALPTH9081OtherPT LICENSE