Individual
LISA RUDOLPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP, AGNP-BC
Contact information
Practice address
55 WATER ST FL 46, NEW YORK, NY 10041-3211
(212) 649-5555
Mailing address
81 HYATT AVE, YONKERS, NY 10704-4314
(716) 697-8342
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F307978-1
NY
Other
Enumeration date
10/21/2016
Last updated
07/02/2024
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