Provider Demographics
NPI:1003070343
Name:RUDZINSKI, CRAIG (RPH)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:
Last Name:RUDZINSKI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 WOODWARD AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14214-1938
Mailing Address - Country:US
Mailing Address - Phone:716-868-9063
Mailing Address - Fax:
Practice Address - Street 1:1979 SENECA ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14210-2387
Practice Address - Country:US
Practice Address - Phone:716-827-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051351-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist