Provider Demographics
NPI:1528496486
Name:NESBITT, PAMELA LUDLOW (EDM)
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:LUDLOW
Last Name:NESBITT
Suffix:
Gender:F
Credentials:EDM
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3553 77TH ST
Mailing Address - Street 2:2D
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-4551
Mailing Address - Country:US
Mailing Address - Phone:212-418-0324
Mailing Address - Fax:212-751-9147
Practice Address - Street 1:292 MADISON AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-6307
Practice Address - Country:US
Practice Address - Phone:212-418-0324
Practice Address - Fax:212-751-9147
Is Sole Proprietor?:No
Enumeration Date:2013-10-30
Last Update Date:2013-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist