Provider Demographics
NPI:1427572668
Name:RUDNICK, CHRISTOPHER GERALD (PT, DPT)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:GERALD
Last Name:RUDNICK
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 BEAVERBROOK RD
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06461-2404
Mailing Address - Country:US
Mailing Address - Phone:203-331-2514
Mailing Address - Fax:
Practice Address - Street 1:4 AVERY ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-1005
Practice Address - Country:US
Practice Address - Phone:617-374-5864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-31
Last Update Date:2017-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty