Provider Demographics
NPI:1457335739
Name:HEGARTY, JUDITH IRENE (MBBS)
Entity type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:IRENE
Last Name:HEGARTY
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8275 MUELLER DRIVE
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601
Mailing Address - Country:US
Mailing Address - Phone:410-819-3749
Mailing Address - Fax:
Practice Address - Street 1:5262 WOODS RD
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21613-3796
Practice Address - Country:US
Practice Address - Phone:410-221-3558
Practice Address - Fax:410-221-2497
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00380902084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDB11153Medicare UPIN