Provider Demographics
NPI:1689770117
Name:RUDZINSKI, JANICE (PT)
Entity Type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:
Last Name:RUDZINSKI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 HOWELL DR
Mailing Address - Street 2:
Mailing Address - City:BRANCHBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-3309
Mailing Address - Country:US
Mailing Address - Phone:908-526-7513
Mailing Address - Fax:908-526-7513
Practice Address - Street 1:150 HOWELL DR
Practice Address - Street 2:
Practice Address - City:BRANCHBURG
Practice Address - State:NJ
Practice Address - Zip Code:08876-3309
Practice Address - Country:US
Practice Address - Phone:908-526-7513
Practice Address - Fax:908-526-7513
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00537900225100000X
NY010571225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ094059Medicare UPIN
NJ2524139Medicare UPIN