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General NPI Number Information
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NPI Number | 1467766311
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Entity Type | Individual
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Provider Name | DANIEL RUDERFER MD
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Gender | Male
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Dates
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Enumeration Date | 08/03/2010
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 19 DAVIS AVE HOPE TOWER 5TH FLOOR
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City | NEPTUNE
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State | NJ
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Zip | 07753
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Country | US
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Telephone | 732-935-0407
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Fax |
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Provider Business Mailing Address
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Address Line | 331 NEWMAN SPRINGS RD BLDG 2, STE 220
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City | RED BANK
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State | NJ
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Zip | 07701-5688
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 271601
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2080P0208X
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Taxonomy Name | Pediatric Infectious Diseases Physician
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License Number | 55392
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 2080P0208X
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Taxonomy Name | Pediatric Infectious Diseases Physician
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License Number | 25MA12377200
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License Number State | NJ
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