Marc S. Rudoltz, M.D.

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

MA61946 Issued in NJ

Practice address

64 Oak Ave
West Orange, NJ 07052-2410

Phone

(973) 736-2883

NPI assigned

Mar 27, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649398363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 OAK AVE",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 OAK AVE",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522410",
            "telephone_number": "973-736-2883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDOLTZ",
        "first_name": "MARC",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NJ",
            "license": "MA61946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyce M Rouse
• Donald Gene Rubenstein, M.D.
• Rubino OB GYN Group PA
• Robert J Rubino, M.D.
• Stephanie Ruch
• Robert A Ruffini, M.D.
• Andrew Ruggiero, DPT
• Kimberly Klimek Ruhl, M.D.
• Brittny Ann Rule
• Deborah Jarow Russ, LCSW

• Radiation Oncology Physician in West Orange, NJ
• Providers in West Orange, NJ by specialty
• Radiation Oncology Physician in New Jersey

• 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.

Verify at the official NPI Registry.