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NPI Code Detail

MEDICARE: DR. RAUL ISIDRO LUDMER MD

MEDICARE: DR. RAUL ISIDRO LUDMER MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician25MA03023600NJ

General Provider Information

NPI Number : 1285846667
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RAUL ISIDRO LUDMER MD
Provider Business Mailing Address
First Line : 88 W RIDGEWOOD AVE
Second Line :
City : RIDGEWOOD
State : NJ
Zip : 07450-3199
Country : US
Telephone Number : 201-445-5692
Fax Number :
Provider Business Practice Location Address
First Line : 88 W RIDGEWOOD AVE
Second Line :
City : RIDGEWOOD
State : NJ
Zip : 07450-3199
Country : US
Telephone Number : 201-445-5692
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2007
Last Update Date : 07/08/2007

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