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Individual

BRUCE A RUDIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
101 HILLSIDE AVE, WILLISTON PARK, NY 11596-2347
(516) 746-7245
Mailing address
101 HILLSIDE AVE, WILLISTON PARK, NY 11596-2347
(516) 746-7245

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
003432
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00763039
NY
Enumeration date
09/26/2006
Last updated
07/08/2007
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