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General NPI Number Information
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NPI Number | 1942409834
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Entity Type | Individual
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Provider Name | PAUL M. RUDKOWSKI RDH
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Gender | Male
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Dates
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Enumeration Date | 07/12/2007
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Last Update Date | 07/12/2007
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Provider Practice Location Address
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Address Line | 1600 MACOMBS RD
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City | BRONX
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State | NY
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Zip | 10452-2016
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Country | US
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Telephone | 718-466-8800
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Fax | 718-466-8870
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Provider Business Mailing Address
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Address Line | 1704 RALPH AVE APT . 3A
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City | BROOKLYN
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State | NY
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Zip | 11236-3302
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Country | US
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Telephone | 917-697-5960
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 024372-1
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License Number State | NY
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