Healthcare Provider Details

I. General information

NPI: 1356865588
Provider Name (Legal Business Name): RACHEL LYNNE RUDO AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2017
Last Update Date: 10/18/2024
Certification Date: 10/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2115 WISCONSIN AVE NW STE 202
WASHINGTON DC
20007-2265
US

IV. Provider business mailing address

3602 PHILIPS DR
PIKESVILLE MD
21208-1719
US

V. Phone/Fax

Practice location:
  • Phone: 202-944-5300
  • Fax:
Mailing address:
  • Phone: 443-839-8090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number01471
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: