Provider Demographics
NPI:1841837820
Name:BEHN, ARDYTH SHANNON
Entity type:Individual
Prefix:
First Name:ARDYTH
Middle Name:SHANNON
Last Name:BEHN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2826 WESTCHESTER AVE RM 201
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-4514
Mailing Address - Country:US
Mailing Address - Phone:718-515-2400
Mailing Address - Fax:718-918-2873
Practice Address - Street 1:2826 WESTCHESTER AVE RM 201
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-4514
Practice Address - Country:US
Practice Address - Phone:718-515-2400
Practice Address - Fax:718-918-2873
Is Sole Proprietor?:No
Enumeration Date:2019-12-09
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024766208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation