Active NPI
Suzanne Rita Rudolph, P.T.
- Physical Therapist
- Kingston, NY
National Provider Identifier
1407064298
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 022225-1
- Practice address
- 164 W Chestnut St Apt 2
Kingston, NY 12401-5947 - Phone
- (914) 466-3655
- NPI assigned
- May 18, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 022225-1 | NY | Primary |
Addresses
Primary practice location
164 W Chestnut St Apt 2
Kingston, NY 12401-5947
Mailing address
164 W Chestnut St Apt 2
Kingston, NY 12401-5947
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 022225-1 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1407064298",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "164 W CHESTNUT ST APT 2",
"city": "KINGSTON",
"state": "NY",
"postal_code": "124015947"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "164 W CHESTNUT ST APT 2",
"city": "KINGSTON",
"state": "NY",
"postal_code": "124015947",
"telephone_number": "914-466-3655"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUDOLPH",
"first_name": "SUZANNE",
"middle_name": "RITA",
"name_prefix": "Mrs.",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "022225-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kingston, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.