Provider Demographics
NPI:1235177171
Name:AHRAM, JUDI
Entity Type:Individual
Prefix:
First Name:JUDI
Middle Name:
Last Name:AHRAM
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 1:7536 HAVERFORD AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19151-2109
Mailing Address - Country:US
Mailing Address - Phone:215-877-4600
Mailing Address - Fax:215-878-3315
Practice Address - Street 1:7536 HAVERFORD AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19151-2109
Practice Address - Country:US
Practice Address - Phone:215-877-4600
Practice Address - Fax:215-878-3315
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT000986E225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA428154Medicare ID - Type Unspecified