Individual
TATYANA RUDAYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
196 CLAWSON ST, STATEN ISLAND, NY 10306-3141
(917) 749-4324
Mailing address
196 CLAWSON ST, STATEN ISLAND, NY 10306-3141
(917) 749-4324
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F403882-01
NY
Other
Enumeration date
12/01/2023
Last updated
12/01/2023
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