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General NPI Number Information
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NPI Number | 1346863198
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Entity Type | Individual
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Provider Name | KATIE RUDZENSKI DO
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Gender | Female
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Dates
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Enumeration Date | 05/27/2020
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Last Update Date | 09/09/2023
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Provider Practice Location Address
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Address Line | 170 MOUNT PLEASANT RD
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City | NEWTOWN
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State | CT
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Zip | 06470-1471
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Country | US
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Telephone | 203-426-1818
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Fax |
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Provider Business Mailing Address
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Address Line | 170 MOUNT PLEASANT RD
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City | NEWTOWN
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State | CT
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Zip | 06470-1471
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OT019944
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 076003
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License Number State | CT
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