MEDICARE: ADINA RUDMAN PA-C

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
1	363A00000X	Physician Assistant	25MP00765300	NJ

General Provider Information

NPI Number	:	1699471813
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADINA RUDMAN PA-C

Provider Business Mailing Address
First Line	:	35 ASCENSION ST APT 16
Second Line	:
City	:	PASSAIC
State	:	NJ
Zip	:	07055-4653
Country	:	US
Telephone Number	:	201-595-9207
Fax Number	:

Provider Business Practice Location Address
First Line	:	35 ASCENSION ST APT 16
Second Line	:
City	:	PASSAIC
State	:	NJ
Zip	:	07055-4653
Country	:	US
Telephone Number	:	201-595-9207
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2023
Last Update Date	:	12/18/2025

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Directions to “ ADINA RUDMAN PA-C” Practice Location

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