Randolph, Audrey L

Randolph, Audrey L is an individual health care provider with primary practice located at 19 Bradhurst Ave Suite 2450N, Hawthorne NY 10532. She recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as her primary health care specialty. Randolph, Audrey L can be contacted via phone (914) 909-4168.

Contact Information

Primary practice address
19 Bradhurst Ave Suite 2450N Hawthorne NY 10532
Phone: (914) 909-4168
Fax: (914) 909-4170
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 097972 New York

Profile Details

NPI number 1912989641
LBN Legal business name Randolph, Audrey L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 17th, 2005
Last updated Feb 27th, 2008 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912989641 NPPES
Other 097972 LICENSE

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