Provider Demographics
NPI:1144523887
Name:HITCHENS, JUDY CAROL
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:CAROL
Last Name:HITCHENS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 PENN MART SHOPPING CTR
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-4209
Mailing Address - Country:US
Mailing Address - Phone:302-322-4658
Mailing Address - Fax:302-322-8939
Practice Address - Street 1:106 PENN MART SHOPPING CTR
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-4209
Practice Address - Country:US
Practice Address - Phone:302-322-4658
Practice Address - Fax:302-322-8939
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-20
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE2010604878332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier