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NPI Code Detail

MEDICARE: ANDREW RUDAWSKY MS, PT, ATC

MEDICARE: ANDREW RUDAWSKY MS, PT, ATC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistJ10000682DE

General Provider Information

NPI Number : 1083645691
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW RUDAWSKY MS, PT, ATC
Provider Business Mailing Address
First Line : 23924 SUNNY COVE CT
Second Line :
City : LEWES
State : DE
Zip : 19958-5695
Country : US
Telephone Number : 302-381-8348
Fax Number : 302-947-9822
Provider Business Practice Location Address
First Line : 101 GARDEN OF EDEN RD
Second Line :
City : WILMINGTON
State : DE
Zip : 19803-1511
Country : US
Telephone Number : 302-477-1536
Fax Number : 302-477-1564
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2006
Last Update Date : 04/08/2008

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