Provider Demographics
NPI:1780672865
Name:ARONOFF, STEPHEN CARL (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:CARL
Last Name:ARONOFF
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 1:2450 W HUNTING PARK AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19129-1302
Mailing Address - Country:US
Mailing Address - Phone:215-707-5437
Mailing Address - Fax:215-707-5180
Practice Address - Street 1:3323 N BROAD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140-5101
Practice Address - Country:US
Practice Address - Phone:215-707-5437
Practice Address - Fax:215-707-5180
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD068037L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0009389560004Medicaid
PA026747LYDMedicare PIN
PA0009389560004Medicaid