Individual
LEAH A RUDNICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7850 JEFFERSON ST NE, STE 300, ALBUQUERQUE, NM 87109-4314
(505) 884-1114
(505) 884-3004
Mailing address
7850 JEFFERSON ST NE, STE 300, ALBUQUERQUE, NM 87109-4314
(505) 688-2653
(505) 883-3076
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
95-335
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
339722104
MEDICARE PTAN
NM
05
—
F4504
—
NM
Enumeration date
07/30/2006
Last updated
05/23/2019
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