Provider Demographics
NPI:1386603769
Name:LAVRICH, JUDITH B (MD)
Entity type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:B
Last Name:LAVRICH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:840 WALNUT ST DEPT OF
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-5599
Mailing Address - Country:US
Mailing Address - Phone:267-733-9686
Mailing Address - Fax:215-928-3983
Practice Address - Street 1:840 WALNUT ST DEPT OF
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5109
Practice Address - Country:US
Practice Address - Phone:267-733-9686
Practice Address - Fax:215-928-3983
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD041810L207W00000X
NJ25MA05502300207W00000X
PAMD-041810-L207WX0110X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0110XAllopathic & Osteopathic PhysiciansOphthalmologyPediatric Ophthalmology and Strabismus Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E72980Medicare UPIN
PA653273FMMMedicare ID - Type UnspecifiedPA INDIVIDUAL MEDICARE
NJ707672CCUMedicare ID - Type UnspecifiedNJ INDIVIDUAL MEDICARE