Provider Demographics
NPI:1417086240
Name:RUDIN, STEVEN BRADLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:BRADLEY
Last Name:RUDIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:117 W 72ND ST
Mailing Address - Street 2:SUITE 5 EAST
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-3204
Mailing Address - Country:US
Mailing Address - Phone:212-874-2213
Mailing Address - Fax:646-514-1915
Practice Address - Street 1:117 W 72ND ST
Practice Address - Street 2:SUITE 5 EAST
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-3204
Practice Address - Country:US
Practice Address - Phone:212-874-2213
Practice Address - Fax:646-514-1915
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2146572084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry