Provider Demographics
NPI:1336699107
Name:RHUDE, ERIC
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:RHUDE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 OAKLAND DR N
Mailing Address - Street 2:
Mailing Address - City:RIVERHEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11901-1520
Mailing Address - Country:US
Mailing Address - Phone:631-208-3767
Mailing Address - Fax:
Practice Address - Street 1:34 OAKLAND DR N
Practice Address - Street 2:
Practice Address - City:RIVERHEAD
Practice Address - State:NY
Practice Address - Zip Code:11901-1520
Practice Address - Country:US
Practice Address - Phone:631-208-3767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-05
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY720185163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse