Individual
MRS. MICHELE LEIGH RUDERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
342 DOWNING DRIVE, YORKTOWN HEIGHTS, NY 10598
(914) 715-3002
(484) 933-3002
Mailing address
35 PROUT LANE, STORMVILLE, NY 12582
(914) 715-3002
(484) 933-3002
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
54851
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
54851
CDN
NY
01
—
916683
RD
IL
Enumeration date
10/27/2006
Last updated
07/08/2007
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