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1568469195

NPI Code Detail

MEDICARE: JUDITH B ODENHEIMER MD

MEDICARE: JUDITH B ODENHEIMER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	49945	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	61030	OTHER		HARVARD PILGRIM POS
2	J05387	OTHER		BLUE SHIELD-INDEMNITY
3	J05387	OTHER		BS-BLUE CARE ELECT
4	049945	OTHER		TUFTS TOTAL HEALTH PLAN
5	D88418	OTHER		FIRST SENIORITY
6	049945	OTHER		TUFTS COMMONWEALTH PPO
7	3009203	OTHER		MASS HEALTH (DIV OF MED S
8	049945	OTHER		TUFTS BENEFIT ADMINSTRATO
9	2056039	OTHER		HEALTHSOURCE MA
10	27616	OTHER		CHILDREN'S MEDICAL SECURI
11	61030	OTHER		HARVARD/PILGRIM
12	J05387	OTHER		HMO BLUE/BLUE CHOICE
13	0016063	OTHER		NEIGHBORHOOD HEALTH PLAN
14	049945	OTHER		TUFTS
15	1240307	OTHER		UNITED HEALTHCARE (PPO)
16	2056039	OTHER		CIGNA HEALTH CARE
17	61030	OTHER		HARVARD PILGRIM PPO

General Provider Information

NPI Number	:	1568469195
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDITH B ODENHEIMER MD

Provider Business Mailing Address
First Line	:	PO BOX 9120
Second Line	:
City	:	DEDHAM
State	:	MA
Zip	:	02027-9120
Country	:	US
Telephone Number	:	781-329-1400
Fax Number	:	781-278-5667

Provider Business Practice Location Address
First Line	:	325 RIVER RIDGE DR
Second Line	:
City	:	NORWOOD
State	:	MA
Zip	:	02062-5027
Country	:	US
Telephone Number	:	781-329-1400
Fax Number	:	781-278-5667

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	07/08/2007

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Directions to “ JUDITH B ODENHEIMER MD” Practice Location

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