Individual
DR. RUDOLPH WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12 KROTIK PL, IRVINGTON EMERGENT CARE AND REHABILITATION CENTER INC., IRVINGTON, NJ 07111-1708
(973) 373-3000
Mailing address
12 KROTIK PL, IRVINGTON EMERGENT CARE AND REHABILITATION CENTER INC., IRVINGTON, NJ 07111-1708
(973) 373-3000
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MA42750
NJ
207Q00000X
Family Medicine Physician
Primary
25MA04275000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0887307
—
NJ
Enumeration date
03/31/2006
Last updated
03/10/2026
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