Basic Information
| Provider Information | |||||||||
| NPI: | 1346551835 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCARDILLO | ||||||||
| FirstName: | JUDITH | ||||||||
| MiddleName: | N | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | MS RN ANP-BC CWOCN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 43 NEW SCOTLAND AVE | ||||||||
| Address2: | ALBANY MEDICAL CENTER MC-73 | ||||||||
| City: | ALBANY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 122083412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5182623958 | ||||||||
| FaxNumber: | 5182626728 | ||||||||
| Practice Location | |||||||||
| Address1: | 43 NEW SCOTLAND AVE | ||||||||
| Address2: | ALBANY MEDICAL COLLEGE DEPARTMENT OF SURGERY | ||||||||
| City: | ALBANY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 122083412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5182620940 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/29/2010 | ||||||||
| LastUpdateDate: | 06/29/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | F305300-1 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.