Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | MA59748 | NJ |
NPI | 1013974971 |
---|---|
Provider Name | Deborah E Rudin |
First Address | Ridgewood, NJ 07450-4496 |
Second Address | Ridgewood, NJ 07450-4496 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2006 |
Last Update Date | 29/10/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
123AR1 | EMPIRE BC/BS# (01) | NJ |
13126 | AMERIGROUP# (01) | NJ |
2K3154 | HEALTHNET# (01) | NJ |
3275469 | AETNA HMO# (01) | NJ |
4462067 | AETNA PPO# (01) | NJ |
8221652 | GHI PPO# (01) | NJ |
91002075400 | AMERICHOICE# (01) | NJ |
F66243 | (02) | NJ |
P00019587 | RAILROAD MEDICARE# (01) | NJ |
P958608 | OXFORD# (01) | NJ |