Ada Ruderman Medical PC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

205782 Issued in NY

Legal business name

ADA RUDERMAN MEDICAL PC

Practice address

1208 Avenue Z
Brooklyn, NY 11235-4302

Phone

(718) 368-2699

NPI assigned

Jan 25, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Ada Ruderman, MDNPI 1114084399

Title

President

Phone

(718) 368-2699

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ada Ruderman, M.D.

  • Pediatric Adolescent Medicine Physician
  • Brooklyn, NY
  • NPI 1114084399
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1327449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327449600000",
    "number": "1679844401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1208 AVENUE Z",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112354302",
            "telephone_number": "718-368-2699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 AVENUE Z",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112354302",
            "telephone_number": "718-368-2699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADA RUDERMAN MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-25",
        "last_updated": "2012-01-25",
        "status": "A",
        "authorized_official_last_name": "RUDERMAN",
        "authorized_official_first_name": "ADA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-368-2699",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NY",
            "license": "205782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01750150",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Acupuncture Practice Althea P.C.
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• Ad Limo Servces Corp
• Ada Pharmaceutical Inc (Brooklyn Chemists)
• Dominique Adair, RD
• Rihanna Micole Chyanne Adair
• Adam B. Pass M.D. P.C.
• Adam RX Pharmacy Inc
• Yara Adam-Whiter, LMHC, CCMHC

• Clinic/Center in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.