Individual
KATHLEEN RUDDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
36 NEWARK AVE, BELLEVILLE, NJ 07109-4119
(973) 450-2710
Mailing address
36 NEWARK AVE, BELLEVILLE, NJ 07109-4119
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
25MA05645200
NJ
Other
Enumeration date
08/23/2006
Last updated
07/08/2007
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