Provider Demographics
NPI:1265831432
Name:NKDHC RUDNITSKY PLLC
Entity Type:Organization
Organization Name:NKDHC RUDNITSKY PLLC
Other - Org Name:NKDHC, PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:RUDNITSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-853-0090
Mailing Address - Street 1:2545 S BRUCE ST STE 200
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89169-1731
Mailing Address - Country:US
Mailing Address - Phone:702-732-2438
Mailing Address - Fax:702-737-5043
Practice Address - Street 1:2545 S BRUCE ST STE 200
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89169-1731
Practice Address - Country:US
Practice Address - Phone:702-732-2438
Practice Address - Fax:702-737-5043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-14
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1265831432Medicaid