Provider Demographics
NPI:1841465143
Name:PEREDO-WENDE, RUBEN A (MD)
Entity type:Individual
Prefix:DR
First Name:RUBEN
Middle Name:A
Last Name:PEREDO-WENDE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4 TOWER PL
Mailing Address - Street 2:8TH FLOOR
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-3715
Mailing Address - Country:US
Mailing Address - Phone:518-489-4471
Mailing Address - Fax:518-489-4506
Practice Address - Street 1:4 TOWER PL
Practice Address - Street 2:8TH FLOOR
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-3715
Practice Address - Country:US
Practice Address - Phone:518-489-4471
Practice Address - Fax:518-489-4506
Is Sole Proprietor?:No
Enumeration Date:2008-04-28
Last Update Date:2016-11-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR15633207RR0500X
MI4301092454207RR0500X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine