Provider Demographics
NPI:1518116763
Name:JUDITH KAHN M.D., P.C.
Entity Type:Organization
Organization Name:JUDITH KAHN M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:E
Authorized Official - Last Name:KAHN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-884-8115
Mailing Address - Street 1:545 W 236TH ST
Mailing Address - Street 2:STE C
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-1710
Mailing Address - Country:US
Mailing Address - Phone:718-884-8115
Mailing Address - Fax:718-884-1487
Practice Address - Street 1:545 W 236TH ST
Practice Address - Street 2:STE C
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-1710
Practice Address - Country:US
Practice Address - Phone:718-884-8115
Practice Address - Fax:718-884-1487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-11
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY163381208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00906189Medicaid
NYA63072Medicare UPIN
NY00906189Medicaid