Provider Demographics
NPI:1912096884
Name:ARTHUR, JUDE KWAME (MD)
Entity type:Individual
Prefix:DR
First Name:JUDE
Middle Name:KWAME
Last Name:ARTHUR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 GRAND CONCOURSE
Mailing Address - Street 2:SUITE 1-C
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-2814
Mailing Address - Country:US
Mailing Address - Phone:718-665-7384
Mailing Address - Fax:718-665-5335
Practice Address - Street 1:860 GRAND CONCOURSE
Practice Address - Street 2:SUITE 1-C
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-2814
Practice Address - Country:US
Practice Address - Phone:718-665-7384
Practice Address - Fax:718-665-5335
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY201138208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01719924Medicaid
NYG44166Medicare UPIN
NY540551Medicare ID - Type Unspecified