Provider Demographics
NPI:1770564882
Name:RUDIN, LOUIS (RPH)
Entity type:Individual
Prefix:
First Name:LOUIS
Middle Name:
Last Name:RUDIN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:370 RUTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-2842
Mailing Address - Country:US
Mailing Address - Phone:201-837-8807
Mailing Address - Fax:
Practice Address - Street 1:370 RUTLAND AVENUE
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-2842
Practice Address - Country:US
Practice Address - Phone:201-837-8807
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037233-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist