Provider Demographics
NPI:1619477197
Name:RUDNICKI, OLIMPIA
Entity Type:Individual
Prefix:MRS
First Name:OLIMPIA
Middle Name:
Last Name:RUDNICKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1370 DARBY RD
Mailing Address - Street 2:
Mailing Address - City:WANTAGH
Mailing Address - State:NY
Mailing Address - Zip Code:11793-2413
Mailing Address - Country:US
Mailing Address - Phone:516-343-3453
Mailing Address - Fax:
Practice Address - Street 1:1370 DARBY RD
Practice Address - Street 2:
Practice Address - City:WANTAGH
Practice Address - State:NY
Practice Address - Zip Code:11793-2413
Practice Address - Country:US
Practice Address - Phone:516-343-3453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-20
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula