Provider Demographics
NPI:1578596581
Name:RUDAT, APRIL (MS ED, RD, LDN)
Entity Type:Individual
Prefix:MRS
First Name:APRIL
Middle Name:
Last Name:RUDAT
Suffix:
Gender:F
Credentials:MS ED, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 JENNIFER ST
Mailing Address - Street 2:
Mailing Address - City:MOSCOW
Mailing Address - State:PA
Mailing Address - Zip Code:18444-6034
Mailing Address - Country:US
Mailing Address - Phone:570-877-5491
Mailing Address - Fax:570-842-7279
Practice Address - Street 1:200 JENNIFER ST
Practice Address - Street 2:
Practice Address - City:MOSCOW
Practice Address - State:PA
Practice Address - Zip Code:18444-6034
Practice Address - Country:US
Practice Address - Phone:570-842-7279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2023-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN000116133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA490007Medicare ID - Type UnspecifiedREGISTERED DIETITIAN