Provider Demographics
NPI:1922395201
Name:ERDFARB, AMICHAI JOSHUA (MD)
Entity type:Individual
Prefix:
First Name:AMICHAI
Middle Name:JOSHUA
Last Name:ERDFARB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3720 INDEPENDENCE AVE
Mailing Address - Street 2:APT 3E
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-1452
Mailing Address - Country:US
Mailing Address - Phone:203-464-4618
Mailing Address - Fax:
Practice Address - Street 1:111 E 210TH ST
Practice Address - Street 2:DEPARTMENT OF RADIOLOGY
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2401
Practice Address - Country:US
Practice Address - Phone:718-920-5506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-07
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2599952085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology