Provider Demographics
NPI:1265131924
Name:AHAVA HEALTH PEDIATRIC NP PLLC
Entity type:Organization
Organization Name:AHAVA HEALTH PEDIATRIC NP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:AHUVA
Authorized Official - Middle Name:
Authorized Official - Last Name:EDELSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:929-464-7709
Mailing Address - Street 1:29 WESTCOTT ST
Mailing Address - Street 2:
Mailing Address - City:INWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11096-1221
Mailing Address - Country:US
Mailing Address - Phone:929-464-7709
Mailing Address - Fax:
Practice Address - Street 1:29 WESTCOTT ST
Practice Address - Street 2:
Practice Address - City:INWOOD
Practice Address - State:NY
Practice Address - Zip Code:11096-1221
Practice Address - Country:US
Practice Address - Phone:929-464-7709
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty