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General NPI Number Information
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NPI Number | 1710076617
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Entity Type | Individual
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Provider Name | JUDITH M WACHENDORF M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 05/19/2015
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Provider Practice Location Address
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Address Line | 7201 ENGLISH DR
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City | CINCINNATI
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State | OH
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Zip | 45244-3147
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Country | US
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Telephone | 513-871-4682
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Fax | 513-871-4682
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Provider Business Mailing Address
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Address Line | PO BOX 9931
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City | CINCINNATI
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State | OH
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Zip | 45209-0931
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Country | US
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Telephone | 513-871-4682
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Fax | 513-871-4682
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 35059405
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License Number State | OH
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