Robert Lawrence Rudin, M.D.
Individual provider Active NPI Internal Medicine Physician · Crum Lynne, PA
NPI 1720026537 · NPPES record last updated Jul 26, 2023
Key facts
- NPI
- 1720026537
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- MD042968E (PA)
- Practice address
- 1553 Chester Pike Ste 101
Crum Lynne, PA 19022-1022 - Phone
- (610) 690-4485
- Fax
- (610) 876-9741
- NPI assigned
- Jun 3, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20061106000262 | PA | Practitioner - Internal Medicine | 0042217044 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA09512100 | NJ | MD | Internal Medicine Physician |
| MD042968E | PA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prospect Health Access Network, Inc. | Current |
Accepting new patients | |
| Prospect Health Access Network, Inc. | Current | Accepting new patients | |
| Prospect Health Access Network, Inc. | Current |
Accepting new patients | |
| CMG Medical Group I LLC | Past | Accepting new patients | |
| Prospect Health Access Network, Inc. | Past | Accepting new patients |
Locations
1 Medical Center Blvd
Ste 301
Chester, PA 19013
Phone (610) 566-6744
1 Medical Center Blvd
Chester, PA 19013
Phone (610) 447-6666
1553 Chester Pike
Ste 101
Crum Lynne, PA 19022
Phone (610) 522-2822
100 W Sproul Rd
Ste 123
Springfield, PA 19064
Phone (610) 619-8281
1324 Macdade Blvd
Woodlyn, PA 19094
Phone (610) 872-2200
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 25MA09512100 | NJ | |
| Internal Medicine Physician | 207R00000X | MD042968E | PA | Yes |
Addresses
Primary practice location
1553 Chester Pike Ste 101
Crum Lynne, PA 19022-1022
Mailing address
524 Williamstown Rd Ste a
Sicklerville, NJ 08081-1800
Phone (856) 728-1181
Other practice location 1
217 Reeceville Rd
Suite C
Coatesville, PA 19320-1572
Phone (610) 384-5110
Other practice location 2
217 Reeceville Rd
Suite C
Coatesville, PA 19320-1572
Phone (610) 384-5110
Other practice location 3
524 Williamstown Rd Ste A
Sicklerville, NJ 08081
Phone (856) 728-1181
Other providers in Crum Lynne, PA
- Julie Petrongolo
- Prospect Health Access Network, Inc.
- Ashish V Rana
- Ridley Crossings Surgical Center
- Ronald Andrew Rose
- S M Vauclain Fire Company
- Michael E Srulevich
- Peter Gore Stein
- Joel S. Tumberello
- Susan L Williams
All providers in Crum Lynne, PA · Internal Medicine Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 26, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.