Provider Demographics
NPI:1316006471
Name:RUDDI BARBOLINI PT PC
Entity Type:Organization
Organization Name:RUDDI BARBOLINI PT PC
Other - Org Name:WILLIAMSVILLE PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RUDDI
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:BARBOLINI
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:716-839-2881
Mailing Address - Street 1:4575 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226
Mailing Address - Country:US
Mailing Address - Phone:716-839-2881
Mailing Address - Fax:716-839-2882
Practice Address - Street 1:4575 MAIN STREET
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226
Practice Address - Country:US
Practice Address - Phone:716-839-2881
Practice Address - Fax:716-839-2882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty