Provider Demographics
NPI:1396738787
Name:CHARNOFF, JUDAH AZRIEL (MD)
Entity type:Individual
Prefix:MR
First Name:JUDAH
Middle Name:AZRIEL
Last Name:CHARNOFF
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 1:1262 OCEAN PKWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-5102
Mailing Address - Country:US
Mailing Address - Phone:718-859-5843
Mailing Address - Fax:718-859-6284
Practice Address - Street 1:1262 OCEAN PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-5102
Practice Address - Country:US
Practice Address - Phone:718-859-5843
Practice Address - Fax:718-859-6284
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY162697207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
000288590102OtherHEALTH PLUS
1626971OtherHIP
2003667OtherAETNA
060059434OtherRAILROAD MEDICARE
2C0986OtherHEALTH NET
162697C15OtherHEALTH FIRST
17F231OtherEMPIRE HEALTH CHOICE
BK0051203OtherAMERICHOICE
0014788OtherAETNA
91304OtherELDERPLAN
NY01146345Medicaid
0308476001OtherCIGNA
442662OtherUNITED HEALTHCARE
BK0051204OtherAMERICHOICE
KS618OtherOXFORD
162697C15OtherHEALTH FIRST
D93250Medicare UPIN