Provider Demographics
NPI:1801858196
Name:RUDIN, ERIC A (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:A
Last Name:RUDIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:110 S BEDFORD RD
Mailing Address - Street 2:MOUNT KISCO MEDICAL GROUP PC
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3446
Mailing Address - Country:US
Mailing Address - Phone:914-241-1050
Mailing Address - Fax:914-767-3142
Practice Address - Street 1:111 BEDFORD RD
Practice Address - Street 2:MOUNT KISCO MEDICAL GROUP PC
Practice Address - City:KATONAH
Practice Address - State:NY
Practice Address - Zip Code:10536-2115
Practice Address - Country:US
Practice Address - Phone:914-241-1050
Practice Address - Fax:914-767-3142
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2016-06-15
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Provider Licenses
StateLicense IDTaxonomies
NY227083207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02796885Medicaid
NY7755N06761Medicare PIN
NYI29628Medicare UPIN