Individual
MISS LISA S RUDNITSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
445 NEPTUNE AVENUE, 12D, BROOKLYN, NY 11224
(917) 502-9994
Mailing address
445 NEPTUNE AVE APT 12D, BROOKLYN, NY 11224-4558
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/05/2017
Last updated
08/11/2017
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