Organization
RICHARD ROUDER, DPM, PC
Active
Other names
SI PODIATRY
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD ROUDER DPM (PRESIDENT)
(718) 556-5550
Entity
Organization
Contact information
Practice address
1855 RICHMOND AVE, STATEN ISLAND, NY 10314-3912
(718) 556-5550
(718) 556-7868
Mailing address
1855 RICHMOND AVE, STATEN ISLAND, NY 10314-3912
(718) 556-5550
(718) 556-7868
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
N005371
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05402
GHI MEDICARE
NY
Enumeration date
06/08/2006
Last updated
07/28/2008
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