Basic Information
| Provider Information | |||||||||
| NPI: | 1386872158 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | STANLEY C. GIUDICI, M.D., M.A.R., P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 75 CRYSTAL RUN RD. | ||||||||
| Address2: | STE. 125 | ||||||||
| City: | MIDDLETOWN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10941 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8456924770 | ||||||||
| FaxNumber: | 8456925199 | ||||||||
| Practice Location | |||||||||
| Address1: | 75 CRYSTAL RUN RD. | ||||||||
| Address2: | STE. 125 | ||||||||
| City: | MIDDLETOWN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10941 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8456924770 | ||||||||
| FaxNumber: | 8456925199 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2009 | ||||||||
| LastUpdateDate: | 06/30/2009 | ||||||||
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| AuthorizedOfficialLastName: | GIUDICI | ||||||||
| AuthorizedOfficialFirstName: | STANLEY | ||||||||
| AuthorizedOfficialMiddleName: | C. | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8456924770 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | 2084P0800X | 231466 | NY | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 2084P0800X | 234957 | NY | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.