Basic Information
| Provider Information | |||||||||
| NPI: | 1528160421 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JUDAH SCHORR MD PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2015 FOREST AVE | ||||||||
| Address2: | SUITE A3 | ||||||||
| City: | STATEN ISLAND | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10303 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7188151000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2 RIVERCREST ROAD | ||||||||
| Address2: | |||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10471 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7186018390 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/01/2006 | ||||||||
| LastUpdateDate: | 12/02/2021 | ||||||||
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| AuthorizedOfficialLastName: | SCHORR | ||||||||
| AuthorizedOfficialFirstName: | JUDAH | ||||||||
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| AuthorizedOfficialTitleorPosition: | MD | ||||||||
| AuthorizedOfficialTelephone: | 7188151000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 12/02/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | 169003 | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.