Provider Demographics
NPI:1467849687
Name:AHARON, DEBRA AVIVA
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:AVIVA
Last Name:AHARON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DEVORA
Other - Middle Name:AVIVA
Other - Last Name:AHARON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:635 MADISON AVE FL 10
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-1009
Mailing Address - Country:US
Mailing Address - Phone:212-756-5777
Mailing Address - Fax:212-756-5770
Practice Address - Street 1:635 MADISON AVE FL 10
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1009
Practice Address - Country:US
Practice Address - Phone:212-756-5777
Practice Address - Fax:212-756-5770
Is Sole Proprietor?:No
Enumeration Date:2015-04-26
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY297767207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program