Provider Demographics
NPI:1790364040
Name:RONALD A. RUDEN SERVICES, LLC
Entity Type:Organization
Organization Name:RONALD A. RUDEN SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:RUDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-321-4547
Mailing Address - Street 1:985 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-0142
Mailing Address - Country:US
Mailing Address - Phone:646-321-4547
Mailing Address - Fax:212-886-8880
Practice Address - Street 1:985 5TH AVE STE 200
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-0142
Practice Address - Country:US
Practice Address - Phone:646-321-4547
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-05
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty