Healthcare Provider Details

I. General information

NPI: 1265831432
Provider Name (Legal Business Name): NKDHC RUDNITSKY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2014
Last Update Date: 03/22/2024
Certification Date: 03/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2545 S BRUCE ST STE 200
LAS VEGAS NV
89169-1731
US

IV. Provider business mailing address

2545 S BRUCE ST STE 200
LAS VEGAS NV
89169-1731
US

V. Phone/Fax

Practice location:
  • Phone: 702-732-2438
  • Fax: 702-737-5043
Mailing address:
  • Phone: 702-732-2438
  • Fax: 702-737-5043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: BENJAMIN RUDNITSKY
Title or Position: OWNER
Credential: MD
Phone: 702-853-0090