Provider Demographics
NPI:1205040458
Name:SCUDDER, ROBERTA C (MSN,RN,NP,C)
Entity Type:Individual
Prefix:MRS
First Name:ROBERTA
Middle Name:C
Last Name:SCUDDER
Suffix:
Gender:F
Credentials:MSN,RN,NP,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:532 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-2116
Mailing Address - Country:US
Mailing Address - Phone:908-232-8077
Mailing Address - Fax:908-232-8447
Practice Address - Street 1:532 E BROAD ST
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-2116
Practice Address - Country:US
Practice Address - Phone:908-232-8077
Practice Address - Fax:908-232-8447
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNN55500163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics