Provider Demographics
NPI:1346422144
Name:PANDOLFE RUCHMAN, ANITA (APRN)
Entity Type:Individual
Prefix:MS
First Name:ANITA
Middle Name:
Last Name:PANDOLFE RUCHMAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ANITA
Other - Middle Name:
Other - Last Name:PANDOLFE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9 HIGH ST CT
Mailing Address - Street 2:
Mailing Address - City:ROCKPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01966
Mailing Address - Country:US
Mailing Address - Phone:978-546-6599
Mailing Address - Fax:
Practice Address - Street 1:9 HIGH ST CT
Practice Address - Street 2:
Practice Address - City:ROCKPORT
Practice Address - State:MA
Practice Address - Zip Code:01966
Practice Address - Country:US
Practice Address - Phone:508-954-6260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-04
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA142013163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult