Provider Demographics
NPI:1114084993
Name:RUDER, LEONARD H (MSW)
Entity Type:Individual
Prefix:MR
First Name:LEONARD
Middle Name:H
Last Name:RUDER
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 PORTERS LN
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-1330
Mailing Address - Country:US
Mailing Address - Phone:203-226-8229
Mailing Address - Fax:203-221-7988
Practice Address - Street 1:1 PORTERS LN
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-1330
Practice Address - Country:US
Practice Address - Phone:203-226-8229
Practice Address - Fax:203-221-7988
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0008951041C0700X
NYPR015818-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNO6601Medicare ID - Type Unspecified