Provider Demographics
NPI:1376843359
Name:RUDOFSKY, SHARYN (OTR/L)
Entity Type:Individual
Prefix:
First Name:SHARYN
Middle Name:
Last Name:RUDOFSKY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 BRADFORD LN
Mailing Address - Street 2:
Mailing Address - City:PLAINSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08536-2326
Mailing Address - Country:US
Mailing Address - Phone:609-233-9232
Mailing Address - Fax:
Practice Address - Street 1:56 BRADFORD LN
Practice Address - Street 2:
Practice Address - City:PLAINSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08536-2326
Practice Address - Country:US
Practice Address - Phone:609-233-9232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-25
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00224700225X00000X
NY010026-1225X00000X
PAOC010472225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist