Provider Demographics
NPI:1184439424
Name:DUDEK, CHRISTEL
Entity type:Individual
Prefix:
First Name:CHRISTEL
Middle Name:
Last Name:DUDEK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1029 STATE ROUTE 26
Mailing Address - Street 2:
Mailing Address - City:WILLET
Mailing Address - State:NY
Mailing Address - Zip Code:13863-1001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1029 STATE ROUTE 26
Practice Address - Street 2:
Practice Address - City:WILLET
Practice Address - State:NY
Practice Address - Zip Code:13863-1001
Practice Address - Country:US
Practice Address - Phone:607-349-7734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY63327701163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management