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Individual

JUDITH AVIVA BORNSTEIN-CHAU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2601 HOLME AVE, PHILADELPHIA, PA 19152-2007
(215) 335-6051
(215) 335-6303
Mailing address
2601 HOLME AVE, PHILADELPHIA, PA 19152-2007
(215) 335-6051
(215) 335-6303

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD435148
PA
208M00000X
Hospitalist Physician
MD435148
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
102275247-0003
PA
05
1022752470001
PA
05
1022752470002
PA
01
2089041
HIGHMARK BLUE SHIELD
PA
01
3712796000
INDEPENDENCE BLUE CROSS
PA
Enumeration date
07/23/2008
Last updated
01/30/2014
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