Provider Demographics
NPI:1053356006
Name:JUDGE, JOAN V (MD)
Entity type:Individual
Prefix:DR
First Name:JOAN
Middle Name:V
Last Name:JUDGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9628
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06535-0628
Mailing Address - Country:US
Mailing Address - Phone:203-397-8000
Mailing Address - Fax:203-389-1540
Practice Address - Street 1:35 MAPLE ST
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06850-3817
Practice Address - Country:US
Practice Address - Phone:203-852-2652
Practice Address - Fax:203-299-5606
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT033661207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT022040OtherHEALTHNET#
CT500HBL073CT01OtherBCBS GROUP#
CT7938972OtherCIGNA#
CT0005966034OtherAETNA/USHC#
CT713482OtherCONNECTICARE#
CT001336610P1OtherBLUE CARE FAMILY#
CT022040OtherHEALTHNET#
CTF93498Medicare UPIN