Provider Demographics
NPI:1689977753
Name:LUDWIG, EILEEN MARY (RN)
Entity Type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:MARY
Last Name:LUDWIG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:465 BLOSSOM RD STE C1
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14610-1842
Mailing Address - Country:US
Mailing Address - Phone:585-546-1600
Mailing Address - Fax:585-546-1618
Practice Address - Street 1:465 BLOSSOM RD STE C1
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14610-1842
Practice Address - Country:US
Practice Address - Phone:585-546-1600
Practice Address - Fax:585-546-1618
Is Sole Proprietor?:No
Enumeration Date:2010-12-13
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY215207-1163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health