Provider Demographics
NPI:1669690061
Name:LUDMER, PAMELA (MD)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:
Last Name:LUDMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 KELBOURNE AVE
Mailing Address - Street 2:
Mailing Address - City:SLEEPY HOLLOW
Mailing Address - State:NY
Mailing Address - Zip Code:10591-1319
Mailing Address - Country:US
Mailing Address - Phone:914-332-1961
Mailing Address - Fax:
Practice Address - Street 1:2900 PURCHASE ST
Practice Address - Street 2:STUDENT HEALTH CENTER
Practice Address - City:PURCHASE
Practice Address - State:NY
Practice Address - Zip Code:10577-2131
Practice Address - Country:US
Practice Address - Phone:914-323-5245
Practice Address - Fax:914-323-5257
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY210653207RA0000X, 2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent Medicine
Not Answered2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine