Healthcare Provider Details

I. General information

NPI: 1275506297
Provider Name (Legal Business Name): ROBERT LUDWIG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2006
Last Update Date: 11/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

519 E 72ND ST SUITE 103
NEW YORK NY
10021-4028
US

IV. Provider business mailing address

519 E 72ND ST SUITE 103
NEW YORK NY
10021-4028
US

V. Phone/Fax

Practice location:
  • Phone: 212-288-1575
  • Fax: 212-288-7616
Mailing address:
  • Phone: 212-288-1575
  • Fax: 212-288-7616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number151323-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: