Provider Demographics
NPI:1841581402
Name:ROBERT D. RUDNICKI M.D., P.C.
Entity Type:Organization
Organization Name:ROBERT D. RUDNICKI M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:D
Authorized Official - Last Name:RUDNICKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-242-5777
Mailing Address - Street 1:701 COTTAGE GROVE RD
Mailing Address - Street 2:SUITE C-230
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-3080
Mailing Address - Country:US
Mailing Address - Phone:860-242-5777
Mailing Address - Fax:860-286-2972
Practice Address - Street 1:701 COTTAGE GROVE RD
Practice Address - Street 2:SUITE C-230
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-3080
Practice Address - Country:US
Practice Address - Phone:860-242-5777
Practice Address - Fax:860-286-2972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-29
Last Update Date:2011-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty