Individual
DR. JONATHAN P LUDLOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV0061121
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02008780
—
NY
01
—
410043899
RRMCR
NY
01
—
52833A
MEDICARE PTAN
NY
01
—
G0185822450
BNY
NY
01
—
TUV006112
NEW YORK STATE
NY
Enumeration date
11/15/2005
Last updated
11/29/2023
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