DR. OTTO JOHN JUDICKE (NPI# 1447319322) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447319322 |
| Entity Type | Individual |
| Full Name | DR. OTTO JOHN JUDICKE |
| Credential | PSY.D. |
| Practice Address |
2 Rehabilitation Way Woburn MA 01801-6003 |
| Mailing Address |
31 Brook St Carlisle MA 01741-1608 |
| Practice Telephone | 8009173422 |
| Mailing Telephone | 9782874845 |
| Enumeration Date | 2006-12-07 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 103G00000X | Clinical Neuropsychologist | 6348 | MA | Behavioral Health & Social Service Providers |
| X | 103T00000X | Psychologist | Behavioral Health & Social Service Providers |
| Street Address |
2 REHABILITATION WAY |
| City | WOBURN |
| State | MA |
| Zip Code | 01801-6003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265428411 | Emily G Lowry | Internal Medicine | 2 Rehabilitation Way, Woburn, MA 01801-6003 | 2005-09-23 |
| 1710509930 | Jacqueline Lyman | Physical Therapist | 2 Rehabilitation Way, Woburn, MA 01801-6003 | 2020-05-11 |
| 1366009540 | Alla Tibbetts PC | Internal Medicine | 2 Rehabilitation Way, Woburn, MA 01801-6003 | 2019-05-23 |
| 1144732868 | Wlb Rehabilitation Medicine Associates LLC | Internal Medicine | 2 Rehabilitation Way, Woburn, MA 01801 | 2017-11-03 |
| 1598276479 | Emily Frances Slowik | Nurse Practitioner | 2 Rehabilitation Way, Woburn, MA 01801-6003 | 2017-10-18 |
| 1518486984 | Lorimer M Kaplan | Occupational Therapist | 2 Rehabilitation Way, Woburn, MA 01801-6003 | 2017-09-16 |
| 1811424120 | Anjum Baqai Md Associates Pllc | Internal Medicine | 2 Rehabilitation Way, Woburn, MA 01801-6003 | 2017-05-17 |
| 1013366624 | Hudgens Pllc | Internal Medicine | 2 Rehabilitation Way, Woburn, MA 01801-6003 | 2016-06-06 |
| 1285083972 | Jason Grunes Pllc | Internal Medicine | 2 Rehabilitation Way, Woburn, MA 01801-6003 | 2016-06-03 |
| 1366809881 | Destiny N Murphy Neurology Consulting LLC | Psychiatry & Neurology | 2 Rehabilitation Way, Woburn, MA 01801-6003 | 2016-01-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184267684 | Leticia Siqueiros | Counselor | Health Care Resource Center Woburn, 9 Forbes Rd, Woburn, MA 01801 | 2019-10-28 |
| 1144882739 | Sarah Martino | Registered Nurse | 7 Alfred Street, Baldwin Park II, Woburn, MA 01801 | 2019-07-03 |
| 1780154005 | Julie Paster-kinnicutt | Social Worker | Lahey Accountable Care Unit, 12 Alfred Street, Suite 207, Woburn, MA 01801 | 2018-11-29 |
| 1164906418 | Amanda Chryslan Scippa | Dietitian, Registered | 2 Oak Knoll Drive, Woburn, MA 01801 | 2018-09-22 |
| 1902383276 | Winchester Physician Associates, Inc. | Occupational Therapist | 100 Unicorn Park, Suite 102, Woburn, MA 01801 | 2018-07-19 |
| 1104317494 | Pauline P Reilly | Dentist | 90 Pleasant Street, Dental Health Care of Woburn, P. C., Woburn, MA 01801 | 2018-05-23 |
| 1134628027 | Caroline Rose Scheck | Behavior Technician | 331 Montvale Ave 5th Floor, Woburn, MA 01801 | 2018-02-06 |
| 1396252425 | Sabrina Voegelin | Social Worker | 410 Russell St, Woburn, MA 01801 | 2018-01-10 |
| 1467975730 | Francine Forbes | Behavior Technician | 10 Gill St., J, Woburn, MA 01801 | 2017-07-19 |
| 1568985851 | Lukasiewicz and Bellavance LLC | Dentist | 3 Baldwin Green Common Suite 101, Woburn, MA 01801 | 2017-07-19 |
| Find all providers in zip 01801 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922164136 | Mary Hinchey Macnamee | Clinical Neuropsychologist | New England Rehabilitation Hospital, 2 Rehabilitation Way, Woburn, MA 02155 | 2006-12-29 |
| 1972675510 | Kira E Armstrong | Clinical Neuropsychologist | 8 Cedar St Ste 43, Woburn, MA 01801-6362 | 2006-11-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154949873 | Erica Rose Appleman | Clinical Neuropsychologist | 134 Horace St, Boston, MA 02128-1581 | 2020-07-09 |
| 1578187613 | Nancy Schneider-pruett | Clinical Neuropsychologist | The Neuropsychology Service, 100 Cummings Center, Beverly, MA 01982 | 2020-06-04 |
| 1194365312 | Erin Grace Kitchener | Clinical Neuropsychologist | 1 Wells Ave Fl 4, Newton, MA 02459-3211 | 2020-01-15 |
| 1407330509 | Coastal Psychological Center, LLC. | Clinical Neuropsychologist | 36 Woburn St Ste 6, Reading, MA 01867-2903 | 2018-09-24 |
| 1881102515 | Matthew S Conway | Clinical Neuropsychologist | 26 Chestnut St Ste 2e, Andover, MA 01810-3600 | 2018-01-16 |
| 1811415326 | Francesca Lavecchia | Clinical Neuropsychologist | Brockto Area Multi Service, Inc. 10 Christy Dr., Brockton, MA 02301 | 2017-09-05 |
| 1346792637 | Margaret Alice Mcphee | Clinical Neuropsychologist | 29 Regina Dr, Chelmsford, MA 01824-4540 | 2016-11-02 |
| 1154870814 | Jessica Pan | Clinical Neuropsychologist | 1 Bowdoin St, 7th Floor, Boston, MA 02114-4201 | 2016-09-22 |
| 1508217506 | Donald Bearden | Clinical Neuropsychologist | 30 Iroquois St, Unit 33, Roxbury Crossing, MA 02120-2848 | 2016-06-30 |
| 1497115612 | Susan Magocsi | Clinical Neuropsychologist | 13 Meetinghouse Ln, Milton, MA 02186-2415 | 2016-03-01 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.