Provider Demographics
NPI:1447781117
Name:JUDY, BRENDAN FOSTER (MD)
Entity type:Individual
Prefix:
First Name:BRENDAN
Middle Name:FOSTER
Last Name:JUDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 SPRUCE ST
Mailing Address - Street 2:8TH FL
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107
Mailing Address - Country:US
Mailing Address - Phone:610-608-0542
Mailing Address - Fax:
Practice Address - Street 1:801 SPRUCE ST.
Practice Address - Street 2:3RD FLOOR - SUITE 302
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5701
Practice Address - Country:US
Practice Address - Phone:610-608-0542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-24
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD485165207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery