Provider Demographics
NPI:1164481628
Name:AHRONHEIM, JUDITH CLARE (MD)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:CLARE
Last Name:AHRONHEIM
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 1:8 REMSEN ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-4138
Mailing Address - Country:US
Mailing Address - Phone:718-270-3323
Mailing Address - Fax:718-270-1831
Practice Address - Street 1:450 CLARKSON AVE
Practice Address - Street 2:BOX 50
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2056
Practice Address - Country:US
Practice Address - Phone:718-270-3323
Practice Address - Fax:718-270-1831
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY136915207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYE48955Medicare UPIN
NY58 F 88Medicare ID - Type Unspecified